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HISTORY OF 

AMERICAN RED CROSS 

NURSING 



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THB MACMXLLAN COMPANY 

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nrru and Eving 



Jane A. Delano 




LAVINIA L. DOCK, R.N. 

Sccry-Ur>'. Intcnutlonal C'vuncU of Nurtr* 





SARAH ELIZABETH PICKETT, B.A. 

AMifUnl to tbc Director, American Bed Crow NunM&ff Service 

CLARA D. NOYES, R.N. 

Saprrintfndml of Trainlnir Schoolt. Bellcrue and Allied UoipiUla. 
T«f% Cttjf: F'trmcr Pniitlfnt. National Lr«Kuc of Nurtlnic Educalfoa; 
ppcatdeni, Anicrtcan Niir«cii' Aflcoclatlon; Dlrpctxr, American 
Rfd (.'TffM Numinir Service 

FANNIE F, CLEMENT, B.A., R.N. 

AnerlctJi B«<I Oroa Town tod Country Xurslng Sendee 

ELIZABETH G. FOX, B.A., R.N. 

■atioiuU Or^'aniution ftif Public llfulth Nurfiinir; 
Public Healll) NursinK Service 



Director, JUnerican Red 



iNA R. VAN METER, B.A., M.S. 

Bflfne Economlr*. Ottln Ststc rnivcrsltjr; Fomier AaalBtant Director, 



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Bt the hacmillan oompaitt. 

Set np and dectrotTpwL PuUiibed December, inu 



J. J. Little * Tvet OotDpanx 
Hew Torfc. D. B. A. 



To 

AMERICAN RED CROSS 

NURSES 




CONTENTS 

CHAPTER L 



RiiLT Growth 

Ori^n of the Bed Cross Idea — Florence Nightingal* 
Nursing in the Cml War — Claru Burton. 

Lavinia L. Dock 



CHAPTER II. 

The Episode of the Spanish-American War .... 25 

Orpiiii7Ation of the Red Cross in 18i)8— The Red Cross 
Sisters — Nursing under the Government — Red Gross 
Aujdli&ry No. 3. 

Lavinia L. Dock 

CHAPTER TIL 

ArnLUTioN op the American Red Cro3b with the 
XrR8E8* Association 67 

The Army Nurge Corps — Hcorganizntion of the Red 
Croee in 1905 — The American Federation of Associated 
Alumnae Accepts Affiliation with the American Red 
Cross — Developmejit of the Nursing Service — Partici- 
pation in Disaster Relief. 

Lavinu L. Dock 



CHAPTER IV. 

Mehct Ship 

The 5.5. Red Cross Sail&— Pai^tnn, Enpland— Pau, 
France — Kief, Russia — Gleiwitz, Germany — Koecl, Ger- 
many — Vienna. Austria — Budapest, Hungary— Belgrade, 
Serbia — Gevgeli, Serbia — Yvt'tot, Frame — La Panne, 
Belgium — American National Red Cross Headijuartcra 
— Close of the Early Foreign Relief !*rogram. 
Sarah Elizabeth Pickett 



139 



Y» 



5^\S<] 




VUl 



CONTENTS 



CHAPTER V, 



MOBIUZATION 



239 



National Headquarters Reorfjanizes — The National Com- 
mittee on Red Cross Nursiug Service — The Committee on 
Nursing of the Council of National Defense — Spwial 
Conrpes — Special Groups — The Army School of Nursing 
— The Nurses' Drives — Surgical Dressings — The Nurs- 
ing Surveys. 
Latinla L. Dock and Sabxh Elizabeth Fickeit 

CHAPTER VI. 

The Relation of the Ncrsing Service to the Army . . 310 

Organization of Units — Base Hospitals — Hospital Units 
— Emergency Detachments — Training School Units — 
Special Units — Cautoiiment Zone Service — Mexican Bor- 
der Service — Equipment and Insignia. 

Sarah Elizabeth Pickett 

CHAPTER VIL 

The European War 387 

Cantonments of the New Armies — Embarkation — With 
the American Expeditionary Forces in Great Britain — 
With the British Expeditionary Forces in France — The 
Zone of the Base, A.E.F. in France — The American 
Red Cross Commission for France — Nurseii' Equipment 
Shop, Paris — With the French Service de i^antS — 
Emergency Hospitalization. A.E.F. in France — The 
Zone of the Advance. A.E.F. in France — With the 
American Expeditionary Forces in Italy — With the 
American Expeditionary Forces in North Russia. 

Saillh Elizabeth Pickett 



CHAPTER VIII. 

Service with the Navy 

Organization of Units — Uniforms and Insignia — Navy 
Nursing Scnice in the Uaited States — Navy Nursing 
Service at Foreign Stations — Detached Service of Navy 
Nurses. 

Sarah Elizabeth Pickett 



t^c/^ 



CONTENTS 



ix 



CHAPTER IX. 

NUBftlNG SeBVICB to THB ClTTUAN POPULATION OF THE 

ALUES 756 

The ChiWren'8 Bureau in France — The Refugee Bureau 
in FTBuee — The Tuberouloeis Bureau in France — The 
Commission for Italy — The First Commission for Rou- 
mania — The Commission for Palestine — The Commission 
for Siberia. 

Sa&ak Elizabeth Pickett 



CHAPTER X. 



\i 



National Heaj>quaeters 953 

Auxiliary Nursing Service — The Summer Months of 
1918 — The Influenza Epidemic — The Armistice is 
Signed. 

Saiiau Euz.vbetu Piokett 

CHAPTER XL 

ThonmiLizATioy 983 

Mifii Delano's Death— The Close of the Military Pro- 
gram Overseas — Bureau of In formation for N urses — 
Nursing Service, V. S. Public Health Service — Casual- 
ties among Xurses — Memorials to Nurses — Red Crass 
Aides — Educational Projects — Military Rank for Army 
Norses. 

Sarah Elizabeth Pigkett 

CHAPTER XII. 

Thk Close of the Fobeigk EiiERaENCY'REUEP Progbam . 1077 

The Commission for Europe — The Commission for Po- 
land — The Commission for tlie Balkan States — The Con- 
traciion of the War Organization. 

Sabau Euzabeth Pickett 



CHAPTER XIII. 

PtiTTIClPATION IN InTEBNATIONAL NrRSINO EDUCATION 

Letgne of Red Cross Societies — Schools of Nursing — 
Iftti Noyes* Trip Overseas — Child Health Centers — 
Kunsing Activities in Insular and Foreign Possessions of 
the L'uited States. 

Clara D. Notes 



1133 



X CONTENTS 

CHAPTER XIV. 

FbOH BuRAL NUBfllKO TO THE FUBLIO HsALTH SbHTIOE . 1211 

Outline of Early Growth — Requirements for Applicants 
— AfBliation Frinciplee Adopted — Growth of Central and 
Branch Units — Early Affiliations — The Interruption of 
War — Scholarships. 

IiA.TiKiA h. Dock and Fannie F. Clement 

CHAFTEB XV. 

Bed Cboss Fublic Health Nitrsinq after the War . . 1293 
Elizabeth O. Fox 

CHAFTEB XVI. 

Class Instbcotion for Women . 1352 

Latinia L. Dock 

CHAPTER XVII. 

The Dietitian Service .1376 

Class Instruction in Home Dietetics — Bed Cross Dieti- 
tians' Service in the European War — ^The Nutrition 
Service. 

Anna B, Van Meter 

Appendix 1443 



ILLUSTRATIONS 
?Bfe A. Delano Froniispiece 

rAcrna riai 

A Group of American Red Cross Sisters who Served at 

Siboney during the Spanish-Amerioau War .... 28 

Indoor I'niform, Gray Drcsa, Apron, Brasaard and Cap, of an 

American Red Cross Nurse , 104 

Insi^ia 116 

Otn Dutton Noyes !832 

Outdoor Uniform of an American Red Cross Nurse . . . 358 

Imerican Red Cross Nurses Washing Their Clothing in an 
Improvised Laundry Set up at American Red Cross 
Evacuation Hospital No. 110, Coincy, France . . . 3G6 

(AboTe) A Recreation House Built by the American Bed 
Cross for the Nursing Staff of the U. S. Army Base 
Hoiipital at Fort ^IcHenry, Maryland. (Below) Nurses* 
Mess, Camp Devens, Masgachusetts 398 

A Nurses' Parade Held in Chicago in 1918 to Stimulate 

Koroiliueut for Militar)* Duty 420 

(Above) Nurses on the Balcony of the American Red Cross 
Nurses' Club. Loudon, Overlooking' the Gardens of Buck- 
ingtiam Palace. (Below) Colebrook I^dge, a Conva- 
Ip^ceni Home for American Army. Nn^y and Red Cross 
Nurses Established at Putney, near London, by the 
American Red Crosa 438 

Nurfe* of a I*. S. Army Base Hospital Marching of! the 

Docks at Brest, France 486 

Airplftne View of Savenav Hospital Ceuter, Medical 
Corpa, A.E.F. in France \ 51? 

A Corner of a Surgical Ward of Amfrican Red Cross Mili- 
tary Hospital No. 1 at Neuilly, France 536 

(Alwve) American Red Cross Militjiry Hospital No. 5 at 
Autenil, near Paris. (Below) The Interior of a Tent 

Ward at AuteuU 608 

xi 



I 



lii ILLUSTRATIONS 

VACUfO rAOl 

A Poster by Robert Reitl, Planned by the American Red 
Croes to Stimulate the Enrollment of Nurses for Military 
Service but Withheld from Distribution at the Request 
of the War Department 622 

A U. S. Army Hospital Train 636 

tJ. S. Army Evacuation Hospital No. (>, at Souilly, France 64(S 

The 112th Field HospiUl. A.E.F., Cohan, France, August 

12, 1918 650 

(Above) Stretch er-Bearers Bringing in a Wounded Soldier 
to a First Aid Station. (Below) First Aid Station, 
168th Reg. Infantry, A.E.F 664 

(Above) Looking Across the Frozen Dvina River to the 
American Red Cross Hospital at Archangel, Russia. 
(Below) Two Types of Ambulance Used by the American 
Expeditionary Forces in North Russia 683 

The U. S. S. Relief 702 

An American Red Cross Child Welfare Nurse with Her 
Charges in the Grounds of the Orphanage and Conva- 
lescent Hospital, Ch/iteau des Halles^ near Lyons, France 780 

(Above) A Group of Patients at an American Red Cross 
Childrcn'B Dippoiisary in Paris. (Below) An American 
Red Cross Children's Dispensary in a Small Town in 

I r I France 804 

(Above) A Tuberculous Refugee Child Who Died in an 
American Red Cross Children's Hospital in France. 
(Below) A Child Who Lived 852 

(Above) Ozpizio Marino, an American Red Cross Hospital 
for Children Suffering from Bone Tuberculosis, at Val- 
doltra, near Trieste, Italy. (Below) A Patient of the 
Otpizio Marino 866 

Refugees Waiting at the Doors of a Relief Station in 

Jeruaalem 896 

(Above) American Red Cross Nurses and Surgeons En Route 
to Vladivostok, Siberia, Visit the lyeysan Temple, Nikko, 
Japan. (Below) Nursea of the Siberian Commission Go 
Shopping at a Market of Manchuria Station . - 930 

Sick Nurses* Quarters, U. S. Navy Ba^c Hospital No. 1, 

Brest. France 1034 



ILLUSTRATIONS xui 

vAcma vAoa 

(Above^ A Ward of the Vilna Military Surgical Hospital, 
Vilna, Poland. (Below) The American Red Cross Or- 
phanage at Liskow, Poland 109S 

(Above) An American Bed Cross Nurse, Jeannie Frasier, 
Instructing Two Pupils of a Little Mothers' Class in 
Elementary Nursing Procedure, Podgoritza, Monte- 
negro. (Below) An American Red Cross Nurse and 
Her Interpreter Giving a Lesson in Home Hygiene and 
Care of the Sick to a Group of Refugees in Tirana, 
Albania 1106 

(Above) The Open Sewers of Tirana, Albania. (Center) An 
American Red Cross Dispensary in Albania. (Below) 
A Mosque of Tirana 1110 

Three Types of Ambulance in the Balkans 1122 

(Above) Roumanian Refugees Living in Mud Dug-Outs in 
the Devastated War Zones. (Below) An American Red 
Cross Nurse Serving Soup to Roumanian Refugees . . 1126 

(Above) First Class of the School of Nursing, Warsaw, Po- 
land, Established by the American Red Cross. (Below) 
Exterior of the School of Nursing, Warsaw, Poland . 1162 

Gray Dress, Cape and Straw Hat Worn by American Red 

Cross Nurses 1212 

An American Red Cross Public Health Nurse on Her Rounds 1340 

A Rural Red Cross Class in Home Hygiene and Care of the 

Sick Gathers at a Cross-Roads Meeting-Place . . . 1372 



FOREWORD 

Perhape of no other figure in American tradition have there 
been more stories written, pictures painted, songs sung than 
of the American Ked Cross Nurse. She has personified 
courage, sympathy and gentle strength in contrast with the 
brutality of war. Yet of her actual character and work little 
is generally known. 

Here is her own story. The experiences of many thousands 
of nurses, selected from personal letters, reports and official 
correspondence and recorded in this history, make it both a 
source book of vital professional significance and a profoundly 
human docmnent For the first time there is properly char- 
acterized and described the magnificent contribution of Amer- 
ican nurs^ in aid of human suffering, not only on the 
battlefield but in all the heretofore hidden places where human- 
ity was miserable because of war. 

President, American National Red Cross. 
The White House, 
Washington, 
Xov. 1, 1922. 



INTRODUCTION 

Since its establishment in 1909, the American Red Cross 
Nursing Service has been the grateful recipient of consider- 
able interest from the nursing profession and from the laity. 
Many requests have come to National Headquarters for data 
regarding its origin, its purposes, its organization and accom- 
plishment. To the answering of these requests. Miss Delano 
and her assistants gave especial care, feeling that the Nursing 
Service could repay this interest only by courteous and intelli- 
gent acquiescence. Nevertheless, the gathering together of such 
data involved the frequent repetition of painstaking research 
and correspondence. 

During and after the European War, such requests were 
greatly multiplied. Nurses and laywomen in increasing num- 
bers wrote to Headquarters to ask for information needed for 
preparing papers for club meetings, speeches or personal nar- 
ratives. Organizations compiling war records asked for his- 
tories of Red Cross nursing accomplishment ; chroniclers of the 
War Department called upon the Red Cross for extensive chap- 
ters to include in the Government's records. Then, too, the 
national officers of the Red Cross shared with the Nursing 
Ser\'ice the opinion that a comprehensive history of Red Cross 
nursing service, of which no adequate account had hitherto 
been written, should be compiled for the use of individuals and 
Chapters. Thus the undertaking which now reaches fruition 
in the publication of this book, was launched in 1919. 

The outstanding editorial policy in shaping this compilation 
was the desire to have an authentic history which would recount 
the methods of work as well as the work itself. By far the 
greatest amount of material previous to the European War lay 
in Red Cross archives, in the Library of Congress and in that 
of the Medical Department of the Array, and the first step 
taken was to engage an expert in research, to assemble, analyze 
and classify the voluminous records. Beatrice Copley (now 
Mrs. Ralph Chapman), M.A., of the University of Illinois, 
came from Chicago to perform this service and our especial 

xvii 



xnu 



INTRODUCTION 



tbankfl and reHuignition are due to her for the admirable way 
in which she carried on her task. 

It was felt that the nurses who had made history in the field 
should be the ones best fitte<] to edit this book which records 
the work done. Early in lOlD an editorial committee whose 
membership was largely that of the National Committee on 
Bed Cross Nursing Service was invited to read and criticize 
the material. No one refused to share the responsibility. The 
members of the committee are: ]Mfll)el T. lioardman, Anna C. 
Maxwell, M. Adelaide Nutting, Annie W. Goodrich, Dora E. 
Thompson, Julia C. Stimsun, Lonah S. Iligbi'e, Lucy Minni- 
gerode, Martha M. Ilussell, Carrie AI. Hall and George B, 
Chadwick. 

As tlie writers to whom the different chapters were entrusted 
completed tlieir pages, each section was 3!d)mitt('d i^ those of 
the Editorial Committee who had been most closely related to 
the work under discussion. While they in no way directed the 
treatment of material, they gave it most carefnl critical read- 
ings and their suggestions were helpful in the extreme. Their 
corrections and revisions were for the most part scrupulously 
incorporated in the text and thus the American Ked Cross ia 
able to guarantee the fidelity of this text to the truth in so far 
as it is humanly possible to interpret it. 

The efforts of the authors have been met by an intelligent 
and eutiiusiastic spirit of helpf»dness from nurs**s and lay- 
women alike. To Miss Boardman, who as secretary of the 
sm'iety was designated by the Central Committee to read and 
judge the manuscript in its entirety, we are deeply and sin- 
cerely gratefid for much patience, encouragement and aid. 
From Dr. Anita Newcomb McGee we have received especial 
aasistance in. the matter of verification of official footnotes and 
of details touching u|hiu her relation to the War Department 
in the Spanish-American War. To JIary S. Fergusson, a 
member of tlie National lleadquarters etlitorial staff and a 
woman of searching intelligence and keen piiwers of criticism, 
whose work on this history was interrupted early in 1022 by 
death, we acknowledge our affectionate and heartfelt gratitude. 
To Mr. Chadwick. whose editorial aid followed the history 
through its many pages, through complexities of securing a 
publisher and through much official "rctl-tape/* we express our 
many thanks. 

Many others have given us editorial assistance, conspicuous 



1 



INTRODUCTION 

ftmoT^ wbom are Dr. Anna Hamilton of France, Mrs. Richard 
Aldrich, Miss Laura Drake Gill, General Merritte W, Ireland, 
Dt. Taliaferro Clark and Dr. Albert Ross Hill. 

In giving us data from correspondence and from their 
wealth of personal recollection and memories, we acknowledge 
our indebtedness to Mrs. Whitelaw Reid, whose secretary, Mr. 
Irving Blake, by her direction opened to us her war nursing 
records, to Dr. Monae Lesser, Mr. Allen Wardwell, Jr., and 
many nurses. We also owe recognition for valuable assistance 
in supplying records to the Librarian of the Library of Con- 
gress and to the Army Medical Library. In gathering our 
illustrations we were helped by the Signal Corps, U. S. A., the 
Air Service, U. S. A., and the Information Section, Naval 
Intelligence, Navy Department. 

To tile hundreds of nurses who have answered our requests 
for information and material and to those whose written ex* 
periences constitute the original sources of this history, we 
offer this volume as our best endeavor to thank them adequately 
for their services in this as in all enterprises of the Nursing 
Service. 



Xational ITeadquarters, 
Washington, 
Xovember 11, 1922. 



Chairman, Editorial Committee. 



•j5^ft/2f!S 




HISTORY OF AMERICAN 
RED CROSS NURSING 



CHAPTER I 

EARLY OEOWTH 

Ori^n of //*€ Red Cross Idea — Florence Nightingale — Nursing 
in the Civil- War — Clara Barton 

THE Red Cross spirit, the motive prompting the work of 
the lutematioual Red Cross, is simply the iustiuct of 
compassion and mercy in a pure f(»rm. Siicli a spirit 
Qugfat be traced down from the beginning of history if a 
genealogical Red Cross tree were desired. In every age 
iQiiminating instances of direct or collateral relationship could 
be found. It is possible, however, to wander too far afield in 
■ aearcii of this kind and a slight sketch will suffice to introduce 
the history of the American Red Cross Nursing Service. We 
need not go farther back than to the Good Samaritan, who 
trpified all the classic characteristics of the Red Cross, the 
^spontaneous, voluntary helpfiilnesa of the private citizen; com- 
^flfcaeion and aid extended freely on the sole ground of common 
humanity; practical skill and intelligence in binding up the 
wounds of the thie%'es' victim; efficient relief work in leaving 
the wounded man to be nursed at the inn and in paying for him 
there. 

Though Red Cross nursing was first developed in connection 
with wjir, not all war nursing in history can be looked upon as 
rudimentary Red Cross service. It has often been solely for 
the furtherance of railiUry projects. The presence of the 
irapersrmal spirit of pity for and the desire to relieve alike both 
friend and foe is the essential characteristic of the Red Cross 
idea, as it ia alao the true ideal in nursing. There is no assure 
tnce that the heroic women of the Gaelic and Teutonic tribes, 

1 





HISTORY OF AMERICAN RED CROSS NURSING 



skilled as tliey were in medical and surgical nursing, who always 
followed their men in war to bind iheir wounds, would rescue 
as readily a stricken enemy, — though it may be that it was bo. 
Haldora, the Dane, in the year 1000 A.D, stands forth as a 
true forerunner of Florence Nightingale and Henri Dunant, 
for she assembled the women of her household afti?r a fierce 
battle and said to them, ''Lt»t us go forth and dress the wounds 
of the warriors, he they friend or foe/* * She herself, it is 
recordrd, fotmd the enemy ciiieftain desperately wounded and 
tfaided him long and skillfully until he was lioaled. 

In tlie medieval orders of the Kntghts Hospitallers with 
their women's branches, are to be found the first organizations 
on a grand scale for nursing and relief work of tlie Red Cross 
type and it is quite possible that their practice and principles 
may have become familiar to Isabella of iSpain, who was the 
first on record among queens to take an intelligent interest in 
the sanitary and hygienic care of her nation's soldiers. 

Those knightly orders, too, imprinted their influence on the 
German women, who in the War of Freedom ( 1S13) fonned the 
first modern women's societies for organized war-relief work 
by volunteers. The armies of Napoleon, on their side, had 
the nursing service of the Sisters of diarity of St. Vincent de 
Paul — the first trained and disciplined nurses of the later 
medieval period to be oiHcially assigned to the care of sick 
and wounded men in war. 

All the heritage of the past and the promise of the future 
met in Florence Nightingale, whose career was opened t(» her 
by the Crimean War. Not only did she there give a complete 
pattern of the many branches of service later developed under 
the Red Cross, but also by what she did she inspired Henri 
Dunaut, the founder of the International Red Cross Committee, 
to his far-reaching achievement. Then by her later efforts she 
created the mtMlern army of skilled, secular, professional women 
from whose ranks the Red Cross Nursing Service is ndw drawn. 
It will be esscTitial, therefore, to preface this record of American 
Red Cross nursing by recalling in some detail the demonstra- 
tion given In' Miss Nightinpile in the CrimeA. 

Her first effurts were of course for the organization of an 
emergency nursing service. For this she had a mixed com- 
pany — at firsit of forty women, some of whom were Sisters of 
Religious Nursiug Orders and others hospital-taught women of 

•Mrs. NoiTie In "A HUtory of Nursing." Vol. 11, p. 813. 



1 



EARLY GROWTH 



8 



old school^ not trained in the modem way, but experienced. 
In al], about two hundrt*d uurBcs bclougi'd to Miss Xightingale'a 
fttaff, — a small group compared with the thousands of nurses 
mobilized during the recent World War, but a group historically 
potent and unique. 

The nursing servieo huviug beeu appointed in its plaee and 
aaaiated hy orderlies and convaleaeent patieuta, Miss A'ighliu- 
gale next organized a laundry service by renting outaide build- 
ifig^ and employing soldiers* wives for the laundry work. Diet 
kiUshiena aroae under her hand from which, for the first time, 
ftiw vronndod men were served with nourishing food, and through 
het etforta the entire kitchen department of the army hospitals 
wtkB syatematically remodeled by the famous Soyer. The dis- 
organization and inetheient management hud been such tliat to 
Mim Nightingale fell tlie task of pun-eying much of the daily 
supplies and clothing of the patients under her care. In a 
ktter to Mr. Herbert, she wrote (Jan. 4r, 1855) : '*! am a kind 
of general dealer in socks, shirts, knives and forks, woikIcu 
spoons, tin baths, tables and forms, cabbage and carrots, operat- 
ing tables, towels, soap, tine ttnith combs, pn.*cipitate for de- 
stroying lice, scissors, bedpans and stump pillows." ^ Presently, 
kits bad been thrown away during a march, she re- 
a large part of the English array. To provide for an 
tt^SCtcd influx of wounded at Scutari, she undertook on her 
own authority to remodel some abandoned wards, engaged two 
hundred workingmen, paid them out of her private resources, 
outtitted the wards and had eight hundred additional beds ready 
when the need came. To have done this through military 
ehannels, at that time, and under the system then in vogue, 
would have taken months. Miss Nightingale's biographer tells 
us that this particular feat, more than any other one thing that 
Ae did, electrified the *'red-tape men'* and spread a sensational 
legiend of the **Kightingale Power.'' She was both fiercely 
eriticLsed and greatly praised for this daring piece of initiative, 
hat Parliament later refunded the money it had cost, thus, in 
effect, endorsing her action. Miss Nightingale urged and 
planned in minute detail the sanitary engineering works later 
carried out in the hospitals of Scutari. She herself considered 
this hfr best piece of work, for hospitals which had formerly 
heen deathtraps, were thereby put on a level with the best, in 
tilation, drainage and cleanliness. These sanitary reforms, 

••a«fe of Florence Nigh ting Ale." by Sir Edward T, Cook, Vol. I, p. 200. 



L^ ing tab 

Is 



HISTORY OF AMERTCAiV RED CROSS NURSING 



in conjunction with her other improveinenta In uurning and in 
the hospital dietary, reduced the army death rate from 42 per 
cent to 22 per thousand of cases treated. 

Though Miss Nightingale dared greatly on her own initiative 
when life and death were in question, yet her habitual order of 
discipline was strict in the extreme and she was punctilious, 
as a rule, in allowing her private stores to be used solely on the 
requisition of the medical officera. Her funds for supplies came 
from her own income^ from other private sources and from the 
Eoyal Bounty. The needs of tho allied armies were not over- 
looked by her. She sent wines and other supplies to the French 
Sisters of Charity. When tho Italian Sistt^rs sulfered a loss 
of their stores through fire, Miss Nightingale dispatched a 
consiprnmout of supplies to them. These were friends. Did 
Miss Nightingale also help the foe? The rules of war often set 
a limit to the merciful impulse, but we may surmise what lier 
spirit was from the story told of the Russian boy prisoner who 
was under her care and who, when asked where he would go 
after death, replied confidently, "I shall go to Miss Night- 
ingale," 

In social service, Miss Nig^itingale opened new paths, hitherto 
as wholly untrodden in the army as had been those of her hos- 
pital reform. Hor nurses' families at home were systematically 
visited and helj)ed by her friends at her request. She brought 
about reforms in the pay of invalided soldiers, and kept in her 
l)edroom much of the officers* money, because if they offended the 
purveyor or the commissary, they were likely not to get it 
She eutabltshed reading rooms for the convalescent patients; 
opened a post otfico and encouraged the men to send their 
money home. She combated drunkenness, to the great derision 
of tho military chiefs. To counteract it she opened a coffee 
house for the men and set on foot reading and class-rooms for 
them. She had schrM^I-maaters sent out from England to teach 
and lecture, and provided maps, books, papers and games. It 
was said of her that she was the first person who ever taught 
oflicials to trt»at the soldiers as Christian men. Nor did sho 
forget the s*>ldiers' wives, many of whom had followed the 
army. She organized a lying-in hospital and secured work for 
them, choosing friendly visitors to go among them and help 
them as needed. 

The war over, Miss Nightingale, as all tlie world knows, with 
the gift in money made to her by the grateful British publici 



1 



EARLY GROWTH 

the Nightingale Training School for Nurses at St. 
i' Kospitii] which was the parent of the modem system 
of nureing. From her, therefore, wo may well date the story 
of the nursing service of the American Hed Cross. 

After the World War a woman of national prominence who 
ksd wtjrked through the Civnl War was asked to point nut the 
gmitest ditTerence W*tween the two wars in the methods of 
participation hy the eiAnlian p»i{nilatiou ; her answer was: ''In 
tlie niirsiug/' This was Ix)ui8a Tvce Schuyler, whose part in 
the orpinization of the School of Nursing at Bellevue Hospital 
in 1873 lends a special interest to the following extract from 
a letter written by her to Miss Clara D. Noyes on the eve of 
the entrance of tlie United States into the World War: 

^ In these days, at the ajre of seventy-nine, when I can not 
very artivc work, my thoughts go back to the early days 
of the Civil War and of what we are trying to do and did 
do then on a very small scale compared with today. We 
wanted nurses for our wiuindod and sick and there wprn none 
to be had- There were no trained nurses in those days, as 
you know. In our New York Branch of the I'liited States 
Sanitary Commission it was as easy to get siipplies as it is 
with the l?ed Cross today. Tlicy poured in from all over the 
country. Our receiving and shipping husiness was enormous. 
Many a time did our loadr 1 wagons take the boxes on short 
notice on Sunday diiwn Broadway to a steamer starting for 
A southern port. We were notified by the Sanitary Com- 
mission of battles to come that hospitals and hospital pupplies 
might he reatiy. Alas ! no trained nurses to be had. Our 
doctors, Elizabeth and Emily Blackwell, provided one 
month's hospital training for 100 selected women who vol- 
unt»'ereii to go as nurses. It was most elementary, but it was 
better than nothing and many of them turned out finely and 
did magnillct'iit wurk later on, and now the' Ked Cross! So 
much to be thankful for if war must come.' 

2ivt only had the United States no trained nurses during 
Civil War, but even the International Coiumittee of the 
Croea did not yet e3Eist. It was in 18(»'i that Henri Duuant 
laid his prop'isals for a relief society l»efore the Society of 
Public Utility of Geneva and in 1804 that the Articles of 

'Analial Report of Hie Natiouiil League of Nursing Education, 19]7| 



6 HISTORY OF AMERICAN RED CROSS NURSING 



Convention touching tbe treatment of the wounded in war were 
Kignod at Geuovu. To this oonveuliou, known aa the Inter- 
national Red Cross Treaty, the United States Government gave 
its accession in 18S2. In the meantime, however, the name 
Rod Cross ulone was lacking during the Civil War, for in tho 
work of relief carried on by the United States Sanitary Com- 
mission a demonstration of ethciency in civilian aid in war- 
time was given, which was nothing less than extraordinary 
for a young nation waging its first war on a grand scala 
Stille in his '^History of the Sanitary Commission'' gives the 
credit for originating Civil War relief work to women. **lt is 
hardly necessary to say,*' he writes, "that tho earliest move- 
ment that was made for any relief was begim by the women of 
the country." 

The United States Sanitary Commission grew out of a mass 
meeting held in Cooper Union, Xew York City, on the 2Gth of 
April, I8C1, which had been called by the Ladies' Relief Com- 
mittee. This oouimittee was the work of Dr. Elizabeth Black- 
well, who had held an infonnal meeting of women and men at 
the New York Infirmary for AVomen and ChildaMU The local 
New York gnnip took the name **Woraen*8 Central Assoeintion 
of Relief" and was, in effect, during the whole war tlie moat 
powerful and iuip»rtant branch of the Sanitary C^)ramiasion. 
Ita leading exenutive officer was Louisa T^o Schuyler. One of 
the purposes of the association was *'to open u bureau for the 
examination and registration of nurses." 

Dr. Blaekwell was personally intimate with Miss Nightingale 
and through her friendship she had a clearer idea, perhaps, of 
what a nurse might be than others had at that time. She 
labored devotedly in selwtiTig and sending numbers of volunteer 
nurses to Bellcvnc Hospital for a month of such training as they 
could p?t there. As the training scIuhjI for nurses was not yet 
founded, tluit experience ctuild have had but slight vahie, yet 
about one hundred of those hastily trained women entered tho 
army hospitals and gave useful aid, many of them cr>ntinuing 
in the sen'iee throughout the war. iliss Niglitingale was in 
close correspondence with Dr. Blaekwell and others on the 
Sanitary Commission and gave them bountifuUy of her counsel 
and advice. She, indeed, in private letters expressed a desire 
to come personally and help them; hut this her fragile health 
prevented. A letter written to the Secretary of War (May 18, 
1861) by the "Women's Central Asftociation of Relief for tbe 




EARLY GROWTH 7 

Sick find WouTided of the Army, acting in conjunction with the 
AdTiftory Coixiniittee of the Boards of Physicians tiud Surgeons 
of ilio Hospitals of New York and the New York Medical 
Aiaociation £or Pumishing Hospital Supplies in aid of the 
Aimy*' ftpealcA of nursing as follows: 

Tbe committee represent that the Women's Central As- 
sociation of Kelief have selected and are selecting out of 
several Hundred candidates one hundred women, suited in all 
reftpe<'ts to become nurses in the general hospitals of the 
Army. These women the distinguished physicians and sur- 
geons of tlie various hospitals in New York have undertaken 
to 4Nittoa(tf aiul drill in a most thorough cund laborioiis manner 
and the coiuniittee ask tliat tlie War Department consent to 
T«<."eive, on wages, these nurses, in such numbers as the 
exigencies of the campaign may require, ft is not proposed 
that the nurses should advance to the scat of war until 
directly called for by tlie Medical Bureau here, nor that the 
governmeut should be at any expense until they are actually 
in ftervice. 

In thifl letter it was stated that the Commission for whose 
reoognition the combined associations were pleading, would, 
•notig other things, '^inquire into the oi-ganizatlon of military 
bocpitals, gtfuerul and regimental, and the precise regulations 
tnd routine thmugh which the services of the patriotic women 
of ibe country may be made avaihihlc as nurses/' As a result 
•f this correspondence and of the efforts of a delegation scut to 
Wa^ington to represent the associations, olfieial mistrust of 
QTOian ▼olunteer aid, which at first had iDeen obstinate, was 
UlaT«!<d: the Surgeou GeneraFs attitude of opposition was 
ahered to one of reluctant cooperation and the formal organi- 
lltioa of the Sanitary Commission proceeded. For nursing, 
the aenricea of religious Sisterhoods, which were promptly 
volunteered^ were the tii-st to be accepted. There were nu- 
tteimift cimvents of Sisters of Charity, Sisters of Mercy, Sisters 
ef St Vincent and others w^here emergency hospitals were 
opeoedf and from whose staffs Sisters and Mother Superiors 
vrre aupplied. Throughout the war a great deal of hospital 
•er * " ^Ms borne by Catholic Sisters, among whom, as espe- 
cL inguishod, were Mother Anthony O'Conaell of Cin- 

ottuitir -Mother Francis of Chicago, Mother Angela of Moimd 
Cxtr and Mf»ther Gonzaga of Philadelphia. The Holy Cross 



8 HISTORY OF AMERICAN RED CROSS NURSING 



Sisters, an Anglican order, conducted imp<irtant hospital work 
at Annapolis and Chester and Sister Adeline Taylor had a 
war nursing record of great variety. 

Much light is tlirown on the condition of hospital nursing 
during the war bv the following intelligent commentary taken 
from Katherine P. Wormeley's small book on the "Sanitary 
Commission." As one who served with the Commission 
throughout, Misa Wormlev has written: 

And here a few words may be said on the work that mi)jht, 
— we dare to say should — belong to Momen in general hos- 
pitals. If women comprehended their true work and liacl tixe 
patience to i*how that they do comprehend it, the deep preju- 
dice ajcaiiitit them, in the minds of the Army surgeons, would 
be removed. 'Indeed it has been removed in many instances. 
But women have not as a general thing, seen their place or 
their duty. It i.s hard, perhaps, to do so. It is hard to 
realize that even benevolence must be obedient. And it is 
for this reason that Sisters of Mercy» so far, have been pre- 
ferred as nurses hy the surgeons of the Army. It could, 
however, be shown that the work of women belonging in the 
world would be more useful than even the work of the Sisters 
if euch women could learn their true place. And if they 
learned it and kept to it, the result would be that in the end 
they would have all the power of benevolence that even they 
would ask. For here it may be said, in deep conviction of 
its truth, that the surgeons of the Army of all grrtdea are, as 
a rule, desirous of doing well by those under their charge 
. . . they are conscientious and faithful men. It is believed 
and is perhaps capable of proof that if a lady (by which is 
meant a gentlewoman hoMing a certain social position) and 
one fitted for the work could i>e placed in charge of what may 
be called the women's department in a hospital . . . namely, 
the nursing of the very sick men, tlie special diet and the 
linen departnicut, with a body of nursew under her charge, a 
benefit fo the hospital would follow, and the surgeons, far 
from complaining of it would in the end welcome it with 
sincerity. 



Ar to the quality of women's work as a whole, Dr. BellowBi 
president of the Sanitary Commission wrote: 

The distinctive features of woraen*8 work in this war 
were magnitude, Ry!*tem, thorough j-fMJperativencss with the 
other sex. ilistinctneKs of purptisc, buainesis-like tlioroughneaa 



EARLY GROWTH 







in Hetails, sturdy persistency to the close. . . . Everywhere 
started up women acquainted with the order of public busi- 
ness: able to call and preside over public meetings of their 
own seJC ; act as secretaries and committees, draft constitu- 
tions and bylaws; open books and keep acx-ountg with ade- 
quate precision . . . enter into extensive correspondence, 
cooperate in the largest, most rational plans. . . . 



* 



I 



iring the progress of the Civil War nursing assumed two 
jeral lypcd: one, a fairly systematic routine iindcr govern- 
ment direction; the otlicr, an original spontaneity of action 
which took its own course and obtained, usually, first the acqui- 
escence and finally tlio help of the Government, Of the former 
trpe Dorothea L. Dix was the official head, having been ap- 
pointed a* Superiuteudeut of Female Nurses by Secretary 
Cameron in June, 1S61. Of the latter type was Clara Ilarlowe 
Barton, the founder in after years of the American Red Cross. 
It is said that Afiss DLx was one of the first to do actual war 
nursings as she took Ciire of boulg of the soldiers who hud been 
wounded iu the Baltimore riots. Her long and remarkable 
career as a reformer of prisons, almshouscf^ and insane asyluma 
(ms th^y were then called) throughout the entire country and 
htr lofty character, made her seem, probably, as precisely the 
one woman to direct the war nursings as Miss Ni^tingale had 
•o Kerned in England. Miss Dix, however, was not a nurse, nor 
bad «he had experience in nursing administration and her work 
in this episode of her life was not on a par with her earlier dis- 
tinguifihod labors. As her character and personality have been 
described, ehe seems to have been in many ways like Miss 
Nightingale. She was slight, delicate looking, graceful, had 
bettn in her vouth beautiful and had a soft musical voict^, with 
winning manners. It was said that her gentle and persuasive 
(ones had a remarkably controlling iniluence over the fiercest 
nuDiar& She was exceedingly quiet and retiring in her deport- 
nent and her success with legislatures was due to gentleness and 
mildneM eovering an unyielding persistence. She cared nothing 
for praise or fame. She preferred not to be talked about. She 
had private means, which she lavished on her w^ork, and her 
labors for the Government were throughout unpaid. Iler 
standards were exceedingly rigid and her individualism was 
intrnite, alienating many of those with whom she had to work 
in a field whore almost everything depended upon suasion. For 



10 HISTORY OF AMERICAN RED CROSS NURSING 

our Government gave Miss Dix, at first, duties but insufficient 
authority and when later her authority was extended, no penalty 
was attaehcd for disobedience. Many of the surgeons resented 
her position. They called her arbitrary, opinionated, severe 
and capricious. Without a doubt she was somewhat severe. 
She mistrusted the young aiid it was said that a woman must 
be "mature in years, plain almost to homeliness in dress and 
by no means liberally endowed with personal attractions, if she 
hoped to meet the approval of Miss Dix.'" 

The second type of Army nurse has been thus described by 
Dr. Bellows: 

Of the labors of women in the hospital aiul in the field . . . 
this Kort of service cannot l>e recorded in the histories of or- 
ganized work. For. far the largest part of this work wa« 
done by fKTKons of exceptional energ)' and some line natural 
aptitude for the servit'c, which was independent of organiza- 
tions, and hardly eubmittod itself to any rule except the 
impulse of devoted love for the work . . . supplying tact, 
patience, and resources. The women wlio did huspiial service 
continually or kept themselves near the base of armies in the 
field, or who moved among the camps, and travelled with the 
corps, were an exceptional class ... as rare as heroines 
always arc, a class rcprciienting no social grade, but coming 
from all . . . but in all cases women with a mighty love and 
earnestness in their hearts ... a love and pity and ability to 
show it forth and to hilwr in belmlf 4)f it. equal to that which 
in other departments of life distinguishes poets, philoso- 
phersy sages and saints, from ordinary men.^ 



It would be a congenial task, if it were possible, to summon 
before our r^-aders the army of Civil War nurses. There were 
in all abottt two thousand, of whom only a few have been re- 
corded with names and histories. 

One of the moat appc»aling was Helen Louise Gilson, of 
Boston, who was 8v> young, girlish and lovely that Miss Dix 
refused to accept her, but who, nevertheless, through family in- 
fluence, followed the Army of the Potomac through all of its 
battles save the tirst and who displayed abilities that remind 
one, often, of the young Florence Nightingale. 

The most nearly approaching in her training to the Red 
Cross nurse of today was Emily E. Parsons, of Cambridge. At 

•"Women*! Work in the Civil War," p. 60, Introduction. » 



EARLY GROWTH 



11 



ttaiei of tbe war Miss Parsons entered tlic Masaaclinsetts 

Mospital for eicperience and remained in it for a 

IT and a half. There was as yvX no school fur nnracs there, 

lit through her social connections she was able tu receive spe- 

ial and careful instruction from the medlL^al men and surgeons. 

The Btorj of Maria M. C. Hall, of WasJiington, and her 

icter, is peculiarly illustrative of the volunteer character of 

inoh Civil War nursing. Like Miss Gilson, Maria Hall was 

*>ectr*d by Miss l)ix as l>eing too young. She tlien went to 

r», Fales, who had gained an independent position in Wash- 

tgton hospitals. Her importunity tinally won Mrs. Fales to 

open the door of a ward, saying as she did so: *'WelI, 

here they are, with everything to he done for them. You 

find work enough." The **girls" stuck to their job, with 

cottntenance from the surgeons. When a general order was 

(Alt for the removal of volunteers from the wards, Maria 

enrolled a« a *'nursc" and drew Army pay, which she fcave to 

Itfce mciL She kept on in this way for a year ''with no recogni- 
txm from any oiHcial soTtrce" ! 
As a contrast to this breezy volunteer there was Sarah Edsoa 
of New York, who strenuously attempted to found a home and 
training school where nurses might bo prepared f4)r the field. 
Sbe Ubored untiringly for this purpose, brought it before the 
S«nitary Commission, went to the Surgeon General and even 
bad « hill embodying her plan brought to a Senate committee. 
Sbe may riglitly Ix? considered as the first to conceive the idea 
of an Army School for Nurses. That she was unable to bring 
hrr phuk to fruition in the intense atmosphere of war does not 
diminish her distinction. The Sanitary Commission regarded 
a training school as unnecessary, thinking that the hospital 
experience itscdf was the best training and that the urgent 
Meds of the moment did not admit of delay sufficient to pro- 
fKK the amateur nurses who were so imperatively called for. 
The Surgeon General seemed at first favorably impressed with 
ICfi. Edwin's idea, but finally discouraged it and signified hia 
I lilMpproval to the Senate committee who iiad her bill in charge. 
^M Every section of the country had its famous nurse. The 
y C\?nfederacY acclaimed Ella K. Nevvsora as "Dixie's Florence 
■ Nightingale." She was a wealthy and beautiful widow when 
~ tbe war broke out, and spent her fortune in hospital and relief 
«ork and nursing. 
Perluips of all the nurses of whom records are left, tlie most 



I 



12 HISTORY OF AMERICAN RED CROSS NURSING 

picturesijue tigoirc and the most widely known is ^'Mother" 
Bickerdvkc. Tnily aiuiuiug stories are told of her cndiirauce, 
her remarkable nursiug and purveying abilities^ her bold 
denuijcialion of rich ^^slackers" who withheld their money from 
war work, and her high hand with ofhcials whose standards 
were less disinteix^ted than her own. 

Finally, none was more closely linked with the present time 
than Amelia Barlow, whose work inspired Captain James 
Serymaer to lake the initial steps that brought alwii^ .* 'i . .1- 
ing of tlie beautiful National Red Cross Heiid^ti.iitei > at 
Washington. 

The hospitals of the Civil War were sometimes temporary 
Adaptations of buildings at hand, sometimes structures hnHily 
erected for the purpose, 8<)motimcs public buildings takev 
for the occasion. The Capitol at Washington was once so u 
and hundreds of wounded were distributed in the Senate, Hoik 
and Rotunda. Hospital ships originated in the Civil War, 
Coast and river steamers wore used. Alany such vessels plied 
on the Ohio and Mississippi rivers with their freight nf . ; >1M 
men. 

In spite of the utmost endeavors of the women volunteer 
nurses, Civil War hospital standards were far bi*low those that 
would be accepted today. The wards were overcrowded, primi- 
tive in e({uipment and meager in provisions for operating 
and for dressing cases. It has Ix^en estimated that during 
those four years approximately six and one-half mUIjon men 
were admitted to hospitals and of them more than 0,^00,000 
were mt^lical cases, no doubt largely preventable, had prevep- , 
tion then bcH.*n understood. Only 425,270 cases were surgical. ■ 

After the war the Army nurses formed an association which 
had its headquarters at Gettysburg. They were wt>nt to mwt 
at the reunions of the Grand Army of the Republic and some 
of their uumlx^r sun'ived the war of lin4. A roster of tlio 
namcB of the members hangs in the present Red Cross Natiojiai 
Headquarters building at Wnshington. 

Their war work endcMl, the women of the Sanitary Comjnis- 
Bion went thi^ir various ways homo and, inspired and Ktrength- 
CJied by their experience, many of them thix-w themselves with 
energy into the work of rt»fonnntion in civil hospitals and other 
institutions. What they had seen had made plain to them the 
need of instnict<*<l, distMplincd nurses ] 



I 



agai 



help 



and counsel of Miss Nightingale, w<»men and men in New York 



EARLY GROWTH 



13 



Ctnada 



City, Boston and New Haven simultaneously established 

f!873) schools for training nnrscfs in thrc?e large hoBpitala: 

• ', the Masaafhu setts Goueral and the New Haveu. 

pioneer stdioola already existing in this country and 

were slrengtheued by this movement and hospitals 

^nerally followed the ex»mple set th(!ni. 

Whilst the new profession of luirsing was thus taking form, 
one of the volunteer workers of whom Dr. Bellows had written 
ti- '•f'-Tf^^Terizatiou quoted on a previous page went abroad 
and there acquainted herself with the work and 
i of the Ked Cross. This was Miss Clara Barton, 
r New England family, whose fixed purpose it trfeB-' 
to bring about the adherence of the United States to 
eneva Convention. Upon her return to her own country 
*"* 'fcas instnimental in forming a Red Cross organization 
'iich was incorporated in the District of Columbia, under 
c nanxe of *'The American Association of the Red Cross" 
and of which she became the first president. As this country 
had ' i * small army and was considered to be on the whole 
a ' nation, it was anticipated that the chief activity of 

a iSaiional Red Cross would be on lines of relief and succor 
in t]nii<s of disaster or natural calamity. Two such calamities, 
tbo Vrllow fever epidemic in Florida (1888) and tlie Johns- 
town Hnod (1880) brought American nurses for the ilrst time 
intu contact with the Red Cross and one of these nurses was 
the wnniau who was destined to become, in later years, the 
head r*the R(*d Cross Nursing Service. 

It is* hardly possible today, for nurses who only know of 

w ffivcr as a preventable and almost extinct disease, to 

its appalling character before the rcHcarch and self- 

Bce of scientific men had discovered its mode of trana- 

Btijiaion. 

A suspicion of the mosquito had, indeed, been put forth as 

tarly as 1S4S, by Dr. .losiah Nott of Alobile, Alabama, but no 

[ctperimontal work had followed his suggestions."^ The writ- 

Dr. Charles Finlay, of Havana, Cuba (1881 and 1886), 

afresh the clinical evidence against the mosquito and 

tntich original force that a Yellow Fever Commission 

Uti appi>inted, whidi brought its investigation to a climax at 

tW time of the Spanish-American War. Major Walter Reed 

^u its bead. Under his direction, at an experimental station 

■8m Paputar Science Monihly, Vol. 23, No. g, p. 6M, article by Ring. 





1^ HISTORY OF AMERICAN RED CROSS NURSING 



in Cuba, the tests of 1(K)0 were carried out % Dr. Jesse W. 
Lazear, Dr. James C'nrroH and Dr. Aristide Agramonti, which 
proved the role in yellow fever of a special variety of raos(]uito, 
tlie StC'gomyin fasciafa. In those tests Dr. Lazcur sacriticcd 
his life, but as a consequence of that work, Havana, other parts 
of Cuba, and, later, the Canal Zone were freed from yellow 
fever and it was shown that, with proper sanitation, the tropics 
could be made safe for white men. 

But these truths were still unknown when Miss Barton's aidea 
went to the help of the fever-stricken South iu 1888. In every 
epidemic of yellow fever, scenes were enacted in Southern cities 
like those of plague times in medieval Europe. The only hope 
of safety of medical men and attendants lay, it was believed, 
in the immunity of acclimated persona, or of those who had 
survived an attack. It was also believed that negroes were 
especially immune. It seemed therefore at that time wise and 
reasonable that, when the Red Cross Society of New Orleans 
was formed (1883), it should have been ruled that no un- 
aeelimated persons, nor any non-immunes, should be used as 
assistants by the Red Cross. Miss Barton's writings refer to 
the well known **01d Howard Association" of New Orleans 
that carrie<I on heroic service in epiibmiies in earli(T days 
under Colonel F. R. Southmayd and that had united with the 
National Red Cross Committee. Wlien the call came from 
Jacksonville for help, Miss Barton expected to supply it. She 
wrote: 

It was arrangotl that the Southern states, through this 
society (the Now Orleans Red Cn)&s] should provide all Red 
Cross nurses for yellow fever, and that the northern part of 
the country should raise the money to pay and provision 
them. We felt this to be a security, and an immediate pro- 
vision which the country had never before known. Fearing 
that tliis might not, at its inception, be fully understood* I 
called at once on Dr. Hamilton, then in charge of tlie Marine 
HoKpital, explaining it to him. and ofTering all the nurses 
tliat could be required, even to hundre^ln, all experienceil and 
organized for immediate action. Perhaps it was not strange 
that a provision so new and r> unknown in the 8ad history of 
plagues and epidemics should have seemed Utopian, and as 
such have been brushed osiile as not only useless, but self- 
seeking and obstructive. Like the entire organization of 
which it was a part, it has to wait and win its way against 
custom or even prejudice. . . . Not realizing the opposition 



EARLY GROWTH 



16 



there might be to our nurses, we called upon their old-time 
leader. Colonel Southniayd, to enlist a body of nurses and 
take theru at once to the fever distriul. He enlisted thirty, 
both men and women, white and colored, and took a part with 
him, the rest following next day.* 

Friction developed between the eorps of volunteer nurses 
flkiaod by Colouel Southmuyd and taken to Jacksonville and 
'% little place called MacClenny, and the local boards of health 
with which the Marine Hospital Service was cooperating. The 
cUsh between the older system of dealing with epidemics and 
the newer, more scientific methods of the Federal and muni- 
cipal health officers was inevitable and Colonel Southniayd was 
withdrawn. These untrained volunteers, of whom there were 
about thirty, some of -whom were of the Negro race, were the 
irat Red Cross nurses in the United Statea. 

It vonld go far beyond our limits to tell the story of the 
Jacksonville epidemic In the daily press of that time the 
geocral picture of distress, terror and death was outlined. 
Thniugh the scene moved many figures brought there by the 
wed, — many of them ministering in faithful unselfishness 
to their knowledge, others preying upon a stricken 
cDommxiity. The personal recollection of a worker in that 
tnnergency is that a strangely debased type of adventurer 
cune to Jacksonville, — immoral, abandoned women and unprin- 
dpled men. Many snch persons were on the lists as nurses 
Biid there were Northern volunteers among them. The Red 
Cron idea had been seized by the pnpular raind and the glamour 
of the brassard made itself felt. Many actors in those scenes 
made and wore on their arms or shoulders the emblem to 
which they had no right whatever. It would, therefore, be 
unfair to judge the status of Red Cross nursing even in that 
formlefis period, by the individuals who claimed to be Red 
CroM workers. 

The local health board very properly deported objectionable 
diaracters to a detention and quarantine camp (Camp Perry) 
bx charge of Dr. Guiteras, tlie yellow fever specialist, and items 
of this kind occasionally appeareil in the New York papers:^ 

For verj* good reasons another nurse will be forwarded to 
Camp Perry tomorrow, . . . the action of the Board of 

•-TTw Red CroM." by CUra Barton, p, 147-148. 
*lj«v York rri6ufi«.' September 22, 1888. 




16 HISTORY OF AMERICAN RED CROSS NURSING 

Health in regard to incompetent and immoral nurses. . . . 
Two other nurses [their names were printed] are at Camp 
Perry, sadder if not wiser women. 



Dr. J. Y. Porter, who was in charge of tlie Government 
relief measures, also had charge of Goveruiueut nurses* Few 
of these were trained aa we count training today, but the 
''Bureau of Nurses and Mc*dical Attention" answered, in all, 
over seven hundred culls for help, llauy of the aides thus sup- 
pliinl were men who hud 8er\'ed in various capacities in hos- 
pitals and were not unfauiiliar with scenes of disease and death. 
The theory of immunity seems then to have been w*nived and 
this was especially so at a temporary hospital on the pavilion 
plan which was erected for the epidemic emergency on the 
sand dunes outside of Jacksonville. It was called the Sand- 
hills Hospital and as early as the ^Oth of August was in charge 
of Dr. Sollice Mitchellj brother of Ncal Mitchell, then presi- 
dent of the Jacksonville Board of Health. 

It is at this time that Jane A. Delano, who later takes so im- 
portant a part in this history, first enters its pages, though 
not through Red Cross channels. Dr. Sollice Mitchell had 
been a Bellevue interne. He had had his surgical service in 
the ward where Miss Delano had been head nurse and through 
his knowledge of lier abilities she was asked to come as superin- 
tendent of the Sandhills Hospital, a position which she filled 
with distinction during her two months' stay. Two of her 
classmates followed her there as volunteers, Wilhelmiiia Weir, 
a Canadian, and Lavinia L. Dock, a Pennaylvanian, each of 
whom had charge of u ward in the hospital- 
Miss Delano's later distinguished service in the Red Cross 
gives a special interest to this, her first public service after 
her training. She had been ouv. of the youngest of her class 
(1886) and had ginie through the hospital so unobtrusively 
and with so unnfi'ceted a quiet and reserve that few of her 
classmates dreamed of the unusual abilities she later displayed, 
although all her hospital work had been well and easily done. 
One of the young internes of that day, who rose to the position 
of Surgeon General of the United States Navy (Roar Admiral 
W. C Braisted) recalled **a singularly clear keen intelligence, 
an abiding sense of duty and an innate resoluteness of charac- 
ter*' as among her characteristics. 

Miss Delano was born in Watkins, New York, in 1862. 



J 



;arly growt] 



I 



Her famllj was a substantial one of New England stock. Her 
father bad died in tlie Civil War and though she was too young 
to remember him personally, his memory remained with her 
uid animated the intense interest that she felt, later, in the 
laldiers and nurses of another war. In appearance Miss 
DfrJano, at Jacksonville, was pleasing without being beautiful. 
Sbe waa tall and of a very calm, self-contained bearing, blue- 
(nrad and brown-haired, with good teeth and a soft line com- 
pkadon. She was quir't and s^^rious in manner and spoke but 
tittle. She wore the Bellevue uniform of blue and white seer- 
andcer with the cap, which increased her youthful look and, by 
cQatrasty made her poise and quietude seem the more impressive. 
Slie was a disciplinarian, and fearless. 

The hospital on the Sandhills was not long needed. After 
ftmnple of months the epidemic abated and the Northern nurses 
and physicians were quarantined and returned to their homes. 
A legend has arisen that Miss Delano, in advance of medical 
knowledge, insisted on the use of mosquito screens in the hos- 
pitaL It was, indeed, thoroughly screened, and this may have 
been her doing. It has been pointed out, however, that Dr. 
Finlay's writings two years before had sounded a warning 
which doubtless made medical men also suspicious of the 
uito. 
r this emergency Miss Delano had twenty years of varied ^ 
before she came under the Red Cross flag. She | 
»|- •• time in a mining camp in Arizona, persuaded to 

go there by Dr. Darlington, later Health Commissioner of 
Xcvr Vork City, who was an old family friend. For five years 
Ae was Bupcrintendent of nurses in the University of Pennsyl- 
tauia Hospital with Miss M. E. P. Davis as head of the hos- 
pJtaL She was one of the first among nurses to take the 
Special Course in Philnnthropy founded by the Charity 
Organization Society of New York City, and she followed this 
by two years* work as head of the Girls Department in the 
Honse of Refuge on Randalls Island. In 1903 she was called 
to be the bend of the training school in Bellevue, her alma 
mater, and held that position for four years. Then for several 
jrean her time was broken by the ill health and death of her 
widowed mother. Absork^d in these cares Miss Delano was, 
from JlHJrt to 1908, sequestered from active nursing associa- 
tioim. Her friends in the later lied Cross work, however, know 
tLat in the Jaekdonville experience she had reached a clear 




18 HISTORY OF AMERICAN RED CROSS NURSING 



conviction of what a nursing; rosorve iiuder the Red Cross might 
mean and of the great uscfulnosa it might have, and they be- 
lieve that her special feeling for the Red. Cross dated from 
that time. 

At Johnstown much of the relief and all the nursing work 
waa carried on under the Red Cross. Philadelphia had a Red 
Cross Society afiiliutcd with the National Association and this 
group sent a staff of medical men and nurses to work in the 
tent hospitals which were used for ill and injured persons. The 
nurses in this corps were rather of the **Staff Nurse, Old 
Style" than of the ultra modern school. They were, however, 
well disciplined and accustomed to working under the direction 
of the physicians who had selected them. Before they arrived 
BellcMie Uospital had again sent a volunteer nurse, Lavinia 
L. Dock, who remained until the others came. Miss Barton 
took a part in the work of relief, leaving the hospital raanage- 
njent to the physicians in charge. After this episode a number 
of years elapsi»d without any special awakening of nurses to 
Red Cross aims. 

On the eve of the war with Spain, which prepared the way 
for the present Red Cross Nursing Sen-ice, it may be well to 
give our readers an impression of the advance of nursing after 
1ST3 and of the main lines upon which It had progressed, with 
some touches of the personality and characteristics of nursing 
leaders. 

The women who had entered the pioneer field of regenerating 
hospitals and opening schools of instruction for pupil nurses 
were women of strong fiber and intense practical idealism. 
They entered a special world, — the old-time hospital world, 
where internal conditions of dirt, disorder, immorality among 
attendants and among patients, bad nursing, coarseness and 
vulgarity were often hidden behind imposing striictures and 
fine outward appearances. Even among those of the best class, 
where respectable attendants and a good tone were found, re- 
forms M'ere diilicult enough because of the gn)tesquely long 
liours, — from twelve to eighteen; the strange survival of sys- 
tems of duty handini down from the Middle Ages, where nursing 
attendants rotated from the wards to the washtubs; the total 
absence of teaching and training, and the generally widespread 
state of satisfaction of nunlical men and hospital dire<'tors with 
their domains; with the resulting resistance, often intense and 
obstinate, to innovations, even though brought in the name of 



EARLY GROWTH 



19 



Florence Nightingale. It has been said of these pioneers and 
their adventures in reform: 

"The women wlio plunged into this public houpeeloaning 
were so absorbed in it that to them, for a time, the outer 
world ceased to exist. It was quite as adventurous, quite as 
exciting, as war nureing. Nurses frora different parts of 
the country met as veterans meet — no other introduction 
neoesaary than their identity of experience. When order 
had l>een restored and time came for conHtructive work, they, 
with one accord the country over, took up the problem of 
giving their ])Upits ampler teaching and a more careful 
preparation than tliey themselves had had. It may be con- 
fidently asserted that never in a modern country has a more 
difinteret^ted and useful civic service been performed by 
women than this regeneration of hospitals by women's boards 
and nurses during the last three deeades of the Nineteenth 
Century. In all estimates of the value of skilled nursing by 
linen of education only half the subject is considered if the 
micnt<? moral uplift that they have given to institutions be 
forgi>tlen or ignored.* 



^ 



A nmubcr of tlie early nursing superintendents bad been 
tcarhers, — for instance, Mary Snively, Louise Darche, Irene 
Sutliffe, Isabel Hampton and Lucy Drown. Others were 
n-pn-seutative Southern women with a capacity for driving 
work before them, such as Lystra Gretter and iliss (Caroline 
Hsnipton, Wade Hampton's niece. By far the most were 
women who had never l>ofore undertaken careers outside of 
tbc family life in which they had been schooled by circum- 

Every section of the country was represented among the 
dden in nursing and many of the strongest hgun-s came from 
Canada, of 5nl>stantial English stock, indomitable, progressive 
wid aerving well the country in which they found opportunity 
to develop their talents. The methods and system of training 
and instruction In their hands had been steadily rising since 
15^73. From the course of two years' hospital work, with in- 
aimction limited to the first year, modeled upon Miss Night- 
b^de's pattern in St Thomas' Hospital, American superin- 
lendenta grad\ially extended classes and lectures throughout 
Ac oourse, provided post-graduate work in special hospitals, 



*-iiaiatory of Nnrsing." VoL III, 



p. 117. 



20 HISTORY OF AMERICAN RED CROSS NURSING 



arranged for affiliation between two or more institutions in 
order to insure wrll-ronndrd experience, Icn^hencd the two 
jpara' course to thref% sliorteiied hours as compared with the 
aystem of ISfiO, fixed more exacting entrance retjuirenieuta 
and made every effort to raise the ethical and professional 
plane. 

Organization on a wide scale began in 1893 with the forma- 
tion of the Society of Superintendents of Training Schools 
for Nurses. The superintendents at once began forming grad- 
lUate nurses into alumniB societies (only two such societies 
had been organized prior to 1S1)3) and these in turn were 
brought together under the name "The Nurses* Associated 
Ahimnse of the United States and Canada." Their first 
regular convention was held in Baltimore, February, 1897, 
There were then two hundred and twenty-one® training schools 
[lin the United States ai»d Canada that were regarded by nursing 
leaders as being already good schools giving a general training, 
or as building steadily toward that end. They were sending 
out, yearly, several thousand trained and taught women. 

The Associated Alunuue had at first been formed in a con- 
servative way by the graduates of twenty of the foremost 
schools, but it rapidly became inclusive of all on a broad gen- 
eral level. The main subject of those early conferences was the 
protection and maintenance of good standards. For progreijs 
was by no means uniform and tX)utinuous. Even worse than 
the direct conflict with the old system, was a swift commercial 
exploitation of the new one. Opposition had sometimes given 
place to an imitation skillfully clothed in the appearance of 
reality. The attractive uniform, the plausible showing of a 
well-graded course of instruction in print, and the "diploma" 
were sometimes cleverly used to dis^iiae purely inoney-making 
institutions, or those of one specialty only, lacking in etpitpment 
and teaching. The methods of the corrcBpondeuce school, 
well enough adapted |>erliap8 to some lines of educational 
preparation for self-support, were beginning to reach into the 
nursing field and thus thirty years and less after the opening 
of the large training schools, there were already almost as many 
different measurements by which to test the **trained nurse" as 
tberw were classes of institutions. Problems of this kind 
brought nurses to consider two principles as basic; first, that 

*Jaiu) Uodaon'a book "I!ow to Become a Ttftined Nurse." listed 200 
(1897 If ttot including forei^ or [KMt-graduiite iKboolft. 



^ up t 



EARLY GROWTH 

minimuin trainiujti: must be gf'neral (i. c, including medical, 
ojil, gynecological and obstetrical experience) ; next, that 
DOTsiDg education and administration -roust be directed by 
mirses. These principles have controlled the nursing profession 
in all its subsequent history. 

Alteorbed then iu educational and disciplinary problems and 
in the extension of their related branches, the nurses of the 
oounlry had not yet been called upon as an organized body for 
any public service, nor had tliey raet any national emergency 
up to tl»e time of the war with Spain. 

In her stay abroad after the Civil War, Miss Barton had 
rbed the European system of Red Cross nursing and war 
of work and had accompanied the German ambulances dur- 
ing the war of 1870. So deeply impressed was she that on her 
retnrn to her own country, she hoped and planned to establish 
tbflt system here. It emphasized the volunteer aid, as shown in 
these Articles: 

TV. In time of peace the committees and sections shall 
train and instruct volunteer nurses. 

V. In the event of war, they shall organize and place 
volunteer nurses on an active footing. 

VI. The committees ^hall send volunteer nurses to the 
field of battle. 

In 1893 a branch of the American National Red Cross was 
organized in New York City and tlirough its etforts a small 
hoapital waa opened which, Miss Bartou hoped, would be the 
fint of many similar institutions and would prepare Red Cross 
Sisters uu the Eumptmn model, for service under the Red Cross 
fit^ This little fouudatiuu, at Erat located in a small rented 
bouse, was formally opened in 1^93 in Miss Barton's presence 
and under her direct auspices. To carry on the hospital work 
and the teaching, Miss Burton had the aid of Dr. A. Monae 
Lcaier and his wife, who shared her enthusiasm for the Red 
Croas nursing of Germany. Dr. Lesser was a skillful surgeon; 
his wife, Bettiua Hofker lesser, who was familiar with foreign 
tt yyitfg systems, was also an American trained nurse, having 
graduated from Mt. Sinai Hospital School for Nurses, New 
York City, in 1803. 

The circular showing the organization plan of the Red Cross 
Hnapital is a real treasure from the historical viewpoint 



22 HISTORY OF AMERICAN RED CROSS NURSING 



Red Cross Hospital & Training 

School for Sisterfi, Xew York, 

833 West 100th Street 



William T. Wanlwell, Presidentj 

A. Mouae Lesser, M. D,, 

Executive Surgeon. 



Under the direct 

auspices of 

The American National 

Red Cross, 

Rt. Hon. Clara Barton, 

President, 

Washington, D. C. 



In order to become a Sister of the Red Cross the applicant 
must be of unquestionable character and qualilicatious. Fur- 
ther, she must — 

1. Take the regular two years and three months* course 
of training nt the Red Cross Hospital; or 

2, Present certificates from some reputahle training 
school for nurses, and take six months' post graduate 
in methods s[)eciall)' applicable to war or other national 
calamity. At the expiration of the course, \ipon giving 
satisfactory evidence of requisite litness. the candidate 
is graduated as a Red Cross Sister and can thereafter 
act as such either at home or abroad. 

In cases of emergency nurses may be enlisted for the spe- 
cial need upon presentation of their certiticatcs nud without 
taking the six months' course mentioned in 2; but it should 
be uuderstofHl that at the close of the service in question their 
relation witli tlie Red Cross ceases, until they can be gradu- 
ated in the regular way. In this connection, however, crtnlit 
will be given for character of work done duriiig the enlist- 
ment 

The certificates above mentioned are: 

a. A certificate of health and character. 

b. Certificate (or a true copy thereof) of graduation 
from training school. 

c. The enclosed blank properly filled out. 

Candidates must have no idea that there is any romantic 
or sentimental attractiveness in the stem demands of war, 
pestilence or famine. The emergencies of the service are 
often trying, sometimes involving privation and danger, and 
only those ready for such work can be of real use. 

The Sisters arc required to be within call at all times, 
ready to respond to any order authorizeil by the President 
of the American National Red Cross. The institution is 
Al>H()lutely neutral and non-8ectarian, not in the sense of 
ignoring, but of respecting every nationality and all religions. 
The Red Cross is a volunteer institution^ guided by and 



< 



I 



I 



GROWTH 

practising regular military tactics. The Sisters are required 
to devote their entire atteution during? the period of their 
service to the work to which they are assigned, and must 
chBerfuIly obey the instructions of their directors. 

No salary is paid, but during actual t^rvice the best avail- 
able provision is made for the support and requirements of 
tlie Sisters. 

Information when and where examinations for ranks may 
be made will be sent upon receipt of signed application. 
Should at any time one be found unfit for certain service in 
the field changes will be made as found proper. 

These rogulatious are made for the purpose of rendering 
best aid to the sufferer, best assistance to the physicians and 
surgeons and to those who devote themselves to attend the 
sick and wounded. 

By order of the 

Right Hon. Ci*.vba Bahton, 

President American National Red CroBs, 
Bettina a. IIofkek-Les8ek, 

Sister-in-Chicf, lied Cross Hospital. 

(For male applicants, read Male Attendant instead of Sister) 

In 1870, vi'hen Miss Barton saw German nursing, it was by 
fio means model. The deaconess's were then the best trained 

id Hed Cross nursing in war j;iine was largely in the hands of 
KtM Moateurs. Twenty years later, when the Now York Red 
OroM Hospital was opened, a number of excellent training 
•diools for nurses had indeed been developed in German Red 
CitMS hospitals, but the whole system on which their nurses 
ircre maiutAiuod and controlled was foreign to American ideas. 
The founders of the Bellevuc school had affirmed the principle 
of economic and professional independence for nurses after 
mrnpleting their hospital course and this was tenaciously held 
to bv ibe young profession, ^fiss Barton and the Tvossers did 
not perceive how much at variance were their nursing ideas 
with those which had been firmly established around them. 
Their hospital organization was destined to fail, — not because 
it was of small beginnings, but because what they were hoping 
to do bad already been done in a different and more enduring 
wav- 

in 1893 when the Red Cross hospital in 100th Street was 
opened, there were all around it in the large training schools 
cd the citv, the very women who later took important parts in 



24 HISTORY OF AMERICAN RED CROSS NURSING 

the Spanish-American War work and still Inter helped to 
perfect the present Ked Cross Cursing Scn^icr. Bnt Miss 
Barton was apparently oblivious of the army of nurses ready 
trained and eager to serve. Older women, w^hosc memory 
reached some years back, recalled the fact that even before 
war was thought of, but as some incident or published word 
brought the Red Cross to the front, nurses had often applied 
individually to know how they could "join the Red Cross" and 
were invariably disappointed at finding no response. 

Yet with the oncoming of the Spanish-American War, the 
New York Red Cross Hospital with pathetic inadeqiiacy stood 
forth to meet the emergency. We do not know how many Sis- 
ters it had trained, nor how much it was prepared to do in 
fitting civilinn nurses for war work, hut it i.s elear that its 
resources must have been but slightj far in a later rt?2>ort Dr. 
Lesser wrote: 

During the last four years, from the time Sister-in-Chief 
Rettina had introduced the idea of training Hed Cross nurpes 
in this countr^v, we had labored with the desire of having an 
adequate number of trained Red Cross Sisters, well known 
to us and upon whose effortK anH eapabihtiep we might rely; 
unfortunately we met with but indifferent success, there being 
no thought of war to stimulate the undertaking," 

As the prospect of war nursing came nearer and nurses 
offered their services in various directions, some to the War 
Department and others to the Red Cross, the Red Cross Ho&- 
pital enrolled all those of attested character who applied to it, 
listing some as fully trained, some as partly trained, and others 
as untrained but capable and intelligent vohinteers, and the 
earliest «)ntingent8 sent out from it rL'pn;sented all of tliese 
groups. A great advance over the chaotic conditions that had 
prevailed in the yellow fever epidemic was even then obvious. 
It has been said that there was "only one adventuress** in the 
first large nursing expedition of the Spanish- American War 
that was recniited almost entirely by the Red Cross Hospital, 
and on the other hand that group included a number of pro- 
fessional and volunteer women whose effective services in 
action soon became well and widely known. 

-••Conduct of the War with Spain." Vol. V, p. 2384. 



CHAPTER n 

TOT EPISODE OF THE SPANISH-AMERICAN TTAR 



I 



Orgamigciicn of the Red Cross in 1898— The Red Cross 
Sisters — Nursing under the Goverfln^€ni — Red 
Cross Auxiliary No, 3 

WHEN the venr 1898 opened, tLe officers of the Ameri- 
can National Red Cross were: Clara Burton, presi- 
dent; George Kennan, vice president; Stephen E. 
Barton, Executive Coniniittee member; David L. Cobb, coun- 
Dr, A- Alouae Lesser and bis wife Bcttina, who were, 
wapectively, executive surgeon and chief of hospitui work. 
Before the United States declared war on Spain, Miss Barton 
hjfcd gone to Cuba with relief for the reconcentrtulos. With hor 
was a BtafF of workers, amou^ them being four Sisters from 
the Red Cross Hospital. In March, the Cuban Relief Com- 
mittee chartered the steamship i<lale of Texas and loaded her 
with food, clothing, medicines and hospital supplies for the 
Cabftns. She was a true Red Cross Relief Ship, sent under the 
Red Cross flag and in conformity with the articles of the Geneva 
Convention, to be turned over to the American National Red 
CrcMH. Miss Barton went to a Florida p<»rt to meet the ship 
and go with it to Cuba, but her plans were frustrated by the 
drclaraUon of war (April 25, 1808) and the Stale of Texas 
did not reach Cuba until she went with the transports convey- 
ing the United iSutes Army, and entered the harbor of San- 
tiago. Instead of aiding reconcentrados Miss Barton had to 
meet the desperate emergency of aiding ill and wounded Ameri- 
can aoldierfli So far only aa the nursing story goes, her efforts 
bo recorded here., but in any estimate of the eharutrtcr and 
of die noraing work it must be remembered tliat this 
tnsk was a very different one from that which Miss Barron bad 
\mak aothorised to undertake, and that much of the criticism 
p«t forth at that time arose from an imperfect understanding 
■fdusfacL 

25 



26 HISTORY OF AMERICAN RED CROSS NURSING 



At iirst the Red Cross Hospital functioned aa its directors 
Lad h<jpcd and meant it should do. At a meeting of the Board 
of Trustees on April 23, 181)8, a eoimnittee was appointed to be 
responsible for a supply of nurses for the war. Sister-in-Chief 
Bettiua (Mrs. Lesser) had a seat on this committee, which 
began at once to plan for calls for nurses. We may fairly say, 
therefore, that the Red Cross Nursing Service was historically 
anticipated at that meeting, by that committee. Soon after- 
wards its services were formally placed at the disposal of the 
Government by Dr. Lesser. 

At the same time a wide reorganization and enlargement of 
Red Cross circles was under way in New York City. This 
was initiated by Mr. William Wardwell, president of the Rod 
Cross Hospital and director of the New York Red Cross 
Society, who, foreseeing the progress of events, brought about 
the formation of a larger ci^mmittee called the "American 
National Red Cross Relief Committee.'' This new commit- 
tee was entrusted by Miss Bart<>u with the task of inviting and 
promoting the C(xiporation of similar conunittees throughout 
the country. Mr. William Wardwell was one of the vice 
chairmen of the enlarged body and Bishop Potter wuh its 
chairman. The Sc(;retury of State (Wm. R. Day) then made 
it known that the American National Red Cross would be 
recognized as "the proper and solo reprosentative in the United 
States of the International Committee," ^ thus fixing the offi- 
cial status of the Red Cn»ss. Secretary Hay also stated that 
Congressional action would protect the insignia of the Red 
Cross from use by any unautliori/xd person. This pmtection 
had not previously been accorded by the United States Govern- 
ment.^ 

The early reports of the Relief Committee gave on the title 
page the names of Miss Barton and other national officers, fol- 
lowed by tliose of the new gnuip in New York City. 

The American National Red Cross Relief Committee as its 
first step had appointed a "Women's Committee on Auxiliaries" 
charged with the duty of organizing similar auxiliary commit- 

' Letter from Ihe Seoretnry of State to the War Department, quoted in 
'*Tho Red Cnws in Peace and War." p. 377. 

'CoHfiTeH did not take the action promiaw! I)v Mr. Day until 1000. 
8«e Congrenaional DifloiiAsinna and Actiona upon Varioua Measiires of 
the Incnrporation of the Red Cross and the Prolwtion of ita Iniiijtnift, 
1894 to I»10, compiled hy Oen. Goorgo W. Davis with hit* Notes on same 
Red Croaa Library, Kationul Heudqiiartera. Washington, D. C. 



EPISODE OF THE SPANISH AMERICAN WAR 27 



tPt* (»f wfimon thrmighout the Uuited Statea. Almost one hun- 
tlrp«l s\\vh auxiliaries were formed, each one taking tip somL* 
one Bpecial rcapoiisibilily. They were designated by numbera. 
The New York group was known as Auxiliary No. 3, but also 
tnok the name **Red Cross Society for Maintenance of Trained 
XuTSP*.*' B<»sides orgnniziug the otliers it became the central 
agency of relief and also thrtingh a committee on nursing, it 
took over and finally controlled the whole Red Cross nursing 
•ervice in New York and iiiUnenced materially the general 
scn'ice during the war. 

Reference will be made again to the new auxiliary's activi- 
ties after following the Rod Cross nurses in Cuba and tracing 
the early steps in nursing which were taken by the Oovem- 
meot 

Dr. Lessers official report^ written after the events, says of 
the first steps taken: 

Immediately after the declaration of war with Spain, I 
Toocived the order from the provident of the American Xa- 
tioual Ked Cross to the effert, **that the Red Cross Hospital 
T M'/nt fhall be ready for service in the war." By the 

I of the president (Miss Barton) all applications 
fur enlistment and communications relating to this service 
were sent to the New York Red Cross Hospital. A certain 
standard of experience and character was eHtahlished as neces- 
sary for enlistment on our staff. A number of applications 
from physicians, nurses and other assistants were received 
. . . and those whoi*e qualifications and recommendations 
seemed satisfactory were chosen and placed upon a list for 
further investigation and final selection. From the large 
number of names of trained and other nurses the Sister-in- 
Chief and I had selected men who we believed would Imj 
physically able to carry wounded soldiers, also trained 
uurses and gentlewomen who seemed least susceptible to 
disease, . . .* 

Wben Miss Barton reached the Cuban shore she took her 
ip to Siboney, where there was need of supplies and aid, and 
her representatives made their way to the Arrny hospital. They 
were not immediately accepted for service there, so carrie<i 
tbeir offers to the Cubuu hospital, where they were gratefully 

"CnnduH of \hc Wur with Spain." Surgeon Oi'ncriira Report, Vol. V, 
S3S4. See jlIbo "Reportti of the Atnericoxi Red Crow Belief Cqcl- 
pw 174. 



28 HISTORY OF AMERICAN RED CROSS NURSING 



accepted. Presently their assistance was asked for by Major La 
Garde of the American forces, in a hospital designated by him, 
and was ^ven. 

The Red Cfoss Sisters, foreign fashion, were called by their 
first names. ^Irs. Lesser, who was Sister-in-Chief, was Sister 
Bettiua. She and Sister Minnie were in charge of the tents; 
Sister Annie with a volunteer assistant, Mrs. White, was in 
the lied Cross Hospital; Sister laabelle and Sister Blanche 
helped with operations. The need of nurses was already 
acutely felt. Dr. Lesser said at this point in his narrative: 

News of another battle was expected. Finally it was agreed 
to request more Red^Cross aifl by telegraph. A call for one 
hundred Sisters was suggested nnd Mrs. lesser was consulted 
in the matter. We had fifty trained nurnes and assistants on 
our lists, also women to art as matrons to distribute nourish- 
ment, etc., whom we hoped we could rely upon. We promised 
to send for that number immediately, as we had sent for 
twenty-five already.* 



i 



I 



The call for the twenty-live nurses here mentioned is of inter- 
est, as it gave tbeir names and was signed by Miss Barton. It 
was sent to Stephen Barton and transmitted by him to the 
Auxiliary Xo. 3, or to the Red Cross Hospital. As it arrived 
in Now York it was written out as here shown: 



Plavadeleste, 

July 2, 1898. 

Barton, New York, 

Williflra Street. 

Siboney — Send nurses nuttell coflin shaw sisters lavinia 

eva gard 5 gardner nitty houligney Anna nuesping raedora 

alien ptnun tleigge hihla olsen e<lith abrams marjraret mcguir 

doctors nuns gill vogel two hundred fifty equipped bed linen 

towels clothes, _, 

Babton.* 



I 



Before completing the story of the adventures of the little 
group of Sisters thus caught accidentally, as it were, in the 
war current, it is necessary to return to the larger evcnta in 



••'Conduct of the War with Spain." Surj;e<>n Gencrara Report, Vol. V, 
p. 37. 

'Files of thp R«J CroM Society for the Maintenance of Trained Nuraea, 
Uaj to July. 1808. 



J 




f^ifjif, lfi»H, bp Clara Hartnn. 

A itroup of American Red Croas Sisters who served at Siboney during the 
Spanish-Amerioau War. 



EPISODE OF THE SPANISH-AMERICAN WAR 29 

Red Crose activity wliich affoeted the Red Crosa Hospital serv- 
ire, uiid to trace tlip steps which liad been taken by Miss 
BartoD'S officers in preparation for war nursing. 

In June, 1898, tlie Departments accepted the offer of services 
made by the Red Cross. Dr. Leaser wrote : 

After the Department of War had approved and accepted 
tlie servic*-? of the Red Cross to gupplement the work of the 
Army Medical Department in case of need, I called, in the 
capacity of Surgeon-in-Chief of the Atiieriiaii National Red 
Cross, uj>on Surgeon General Sternbiirg of the United States 
Army. I was acTompanied by the Sister-in -Chief. We asked 
the Surgeon General for information in regard to field service 
— in his opinion a hospital ship would be the best service that 
»c mii^tit render. He, however, referred us to Colonel Green- 
leaf, who. he said, would have charge of the field. After a 
short interview the Colonel said that he felt there would be 
^ land service and that it would be wise for us to be pre- 
pared.* 

The story now returns to the place where the Red Crosa 
Sisters were left at work with Dr. La Garde. The need of 
Durse« had grown steadily more urgent and tinally, as already 
reeorded, a number were cabled for. Dr. Lesser wrote : 

That morning Miss Barton, with George Kennan and 
several of her stalT, had gone to the front and before leaving 

"iss Barton instructed her secretary, Mr. C. H. H. Cottrell, 
in the presence of Mrs. lesser and myself, that at our request 
be phould cable in her name for such persons and material 
fts should he needed in the hospital department. Since it 
was the wiftli of the surgeon of the camp, we cabled first by 
name and then by special list for fifty nurses, ten assistants, 
a number of immune physicians and complete hospital equip- 
ment to make at least five hundred patients comfortable. The 
woundt'd continued to arrive for four days*. Surgeon Major 
La Garde did me the honor of consulting me in regard to the 
nursing and I suggested tluit ^uua of the Sisters leave the 
ojierating tables and take tharge of the jmtients in the tents. 
The rows of te.nt^ were then plared in her (Mrs. Lesser's) 
charge and she portioned the work of caring for them among 
the Sisters assisted by hospital corpsmen.' 

*IUport«, American Kotional Red Cross Rolipf ComraUtiws, p. 177. 
•*^Cowlnct of the War with Spain." SurgeoD Generil's Report, Vol, V, 
pp. «388^238»-2391. 



30 HISTORY OF AMERICAN RED CROSS NURSING 

In the midst of this arduous work, July 15, Dr. Lesser and 
all his nurses were striekeu down by yollow fovor. It was sup- 
posed that their little Ked Cross hospital, whie.h had been wn- 
struoted in a Cuban dwellings was infected. At the time nnieii 
controversy went on as to who was blaniablc, but since the mode 
of transmission of yellow fever was then still uudeni ' "ated, 
the criticism and hard fooling engendered by those utsputes 
were futile. Meantime Dr. La Garde waited impatiently, in 
^reat need, for the expected reenforeement of nurses. Still 
ithey did not come. They had, however, been dispatched from 
New York by the Auxiliary No. 3. Dr. Leaser's story tells us: 

In tlie meantime word from Assistaj^t Surgeon General 
Oroenlcaf was received at Siboney, stating that fortj'-five Ked 
CroHS Sisters, surgeons and other assistants had arrived at 
Guantanamo, waiting to come to us, and as we returned the 
same day from the fever camp. Surgeon Major Ia Carde 
telegraphed and telephoned repeatedly for them to come, but 
he received no reply. Feeling that under existing circum- 
stances, and exhausted from work and ilhicsf, we could not 
continue to work without more assistance, I applied for our 
return.' 

Dr. lesser and the Sisters went north on the steamship 
Concho from SiUmey to New York (about August 24), but no 
record of the Sisters- subsequent activities have been found. 
Concealed at first by the absence of surnames, it is quite possible 
that they returned into war work under their ordinary titles. 

The lied Cross hospital had already lM?gun losing its preced- 
ence because of the larger organization growing up around it. 
At the time of Miss Barton's entrance into Cuba, Dr. Lesser 
had urged that twelve Rt»d Cross Sisters and several others 
8ckH!ted by Sister Bottina should be sent on the Sfatr of Texas 
to join the four who were awaiting them in the Soutli, but for 
fiomc (undoubtedly valid) reason they wore not sent, to liis 
great chagrin. At this point the opening first appears of that 
transition process in the nursing system of the Red Cross which 
led from the little group of volunteer Sisters to tlio highly 
modernized Nursing Service of 1017," and sucli periods are 

• "Conduct of the War with Spain," Surgeon Gcnerarg R«port, Vol. V, 
p. 2.103. 

'For fuller detfliU r^: Rfp^irtd ftf the Amprican Red Crops Rctipf 
(k^mmitteefl, p. I7ft, nnd *'Con<hict of llic War with Spain," Sur(iccii> 
General's Report. Vol. V. p. 238 U 



EPISODE OF THE SPANISH-AMERICAN WAR 31 

painful to those who iiud themselves displaced. One cannot 
but feel that the Lessors did not have a "good chance" and that 
SUter Bettiua might have administered easily the larger staff 
of Duree« that she vainly tried tn secure. 

To return to Dr. La Garde; the failure of the nurses so 

aigerly awaited and so much needed, to reach him, had its 

explanation in the unwillingness of the Surgeon General's 

omc<» to send nurses into Cuba who were not known to be im- 

^AiiUL' to yellow fever, for l)r. Sternberg was very careful on 

^tflia point Other reports of those strenuous days confirm I>n 

jBHter's story and among several reference's to the nursing situa- 

Cbn of that time that are to be found in the report of Dr. 

Charles R. Oreenleaf, Chief Army SurgiH>u in the Field, one 

explains why Dr. La Garde aid not receive his reenforcement 

of nurses: 

On the 18th of July we proceeded to Guantanamo Bay, the 
rendezvous for the Porto Rican expedition. At this place 
we found a dotaehment of doctors and female nurpcs on board 
the steamship Lampasas that had been sent to work with 
the Ked rros^s Association. Ae they wiuld not go into Cuba 
or land from their own ship, I determined to use them in 
Fthe Porto Rican expedition, and subsequent events demon- 
atrated the wisdom of this action, i?inco the increase of typhoid 
fever cases on board the Pteaniship Yulf. was very large, re- 
quiring the transfer of some eighty odd to the ship on which 
these nurses were quartered, which I converted into a quasi- 
ho»pital ship, notifying the medical officers in charge of the 
various transports to send their sick to it, and with them 
.descrijjtive lists, complete transfer lists, and sufficient qiianti- 
Mes of medical supplies and rations to last during the return 
voyage to the States."* 

T in the summer a report on this expedition was s*»nt to 
American Red Cross by one of the party, Miss Itutty, who 
had been placed in direct charge of the trained nurses. She 
wtk» not a nurse, but had been efficient and practical and showed 
gifta of management. Her report is included at this point, 
becAUae it is a connecting link between the Ked Cross Hospital 
war work and that of the Auxiliary No. 3. Addressed to Sister 
Beitina, as still holding the position of Sister-in-Chief, the re- 
porta of the Auxiliary to be given later show that the Lampasas 

•**Condiu't of tlte Wiir with Ppatii,*' Report of the Surgeon General, 
'^M, t> pp. 036-038. 



32 HISTORY OF AMERICAN RED CROSS NURSING 

party, though made up chietly at the hospital, was merged in 
the general department of admiuistratioii of the auxiliary. 

Report of thk Hfm Choss Expkdition Aboard 
TME S. S. Liimpasas 

To Betlina Rofker Lesser, Sister-iu-Chief, Americ&u 
National Red Cross 

Left New York July 4 in tharge of nine nurses, one 
surgeon and two assistant nurgeons, under orders to conduct 
party to Cuba. Miss Anna Boligny according to orders 
joined us at Washington. At the Port of Tampa we joined 
Miss Gill and her party, and under instruction from Mr. 
Stephen Barton put up at Tampa Bay Hotel, and waited for 
transportation. The conduct of the nurses while at Tampa 
was espei-ially commended by the officers of the Army and 
Navy with whom they came in contact. On the night of 
July 7, Major Carter of the Divisional Hospital, General 
Snyder's Camp, Picnic Island, asked for nurses for typhoid 
nursing. For this service two night nurses and two day 
nurses were detailed for duty during our etay in Tampa. 
July 8 we boarded the S. S. Lamftasas, and on July 12 Bailed 
from the Port of Tampa, Miss Uill having given into my 
hands all matters pertaining to the finances of the combined 
parties. Arrived at Key West evening of July 14. At Mr. 
Cobb's request I went ashore to cable to New York for funds. 
Ship sailed before answer came. We were instructed to re- 
main on board the Ijampamis at Santiago until Ked Cross 
orders came. Sailed into harbor of Santiago morning of 
July 19. Colonel Black having gone ashore for orders, re- 
ported that nothing could be learned of the Red Cross 
authorities; that on account of the presence of yellow fever, 
anclior would be weighed at once, and all communication 
would l>e cut off. As we were imder orders not to leave the 
ship until so instructed, we sailed to Guantanamo. On the 
morning of the 30th gave orders that the Red Cross party 
was to be ready to leave the sliip at noon. Orders from 
General Miles that we go on board the Oregon and return to 
Santiago. An interview being had with General Miles, he 
authorize<l us to remain on board while awaiting orders, and 
Bueh orders failing us said he would gladl)' utilize ut; at the 
front. An ad<litional order came from General Miles that 
all immune nurses should be detailed for work at Santiago. 
Mr^. Bull, the only immune in our number, was transferred to 
the Oregon in company with Miss Wheeler who had special 



EPISODE OF THE SPANISH-AMERICAN WAR 33 



permission to join her father. Colonel Black kindly put rae 
ashore, where I cahlod to Mr. Stephen Barton explanations, 
id unkiu^ for fuuds and supplies. Colonel Ureenleaf had 
tated that the supplies at hand were only adequate for the 
needs of their own surgeons. Itumor reached us at this time 
that Dr. and Mrs, Lesser were very ill with yellow fever, and 
Mies Barton having failed to respond to a message sent by 
Mre. >Iutall in charge of the party on the Kueccs and no word 
r*»thing us from Dr. Barton, we sailed for Porto Rico. Hav- 
ing learned that it was ahsolutely necesparj* for our future 
usefulness that an organization he formed, the nurses and 
doctors held a mass meeting on July 22 and elected me direc- 
tor and Sister-in-Chnrge. Sailed into Guanira iluly 25 and on 
same afternoon received sixteen patients from Comanche, 
Following morning fifty-seven came from Yale. Anchored 
off Ponce, evening of 28. Quarantined by Dr. D. R. Burns 
on account of three ca.ses of measles and pemphigus. Re- 
moval of quarantine on 31st. On July 31 we were asked to 
proceed north with our patients. Colonel Greenleaf did all 
in his power to assist us and requested me to proceed to 
Wasliinglou to report to Surgeon General iSteruherg at the 
earliest possible opportunity. Sailed August 1st leaving Miss 
Chanler and Miss Boliguy at Ponce at their special request, 
and with General MiW sanction. According to instructions 
we landed our one hundred and two patients at the general 
huspital, Fortress Monroe, August 7. From Fortress Monroe 
1 proceeded to Washington and delivered Colonel Grcenleaf's 
jlttter to Surgeon General Sternberg, going thence to New 
^"York and reporting to Red Cross authorities on August 9. 
We now await further orders. Special mention should be 
rnnde of Mary E. Gladwin, whose management of the diet 
kitchen merita the greatest credit and appre<nation on the 
irt of those who worke*! with her and also of the National 
terl Cross. Beatrice Von Homrigh was most efficient in 
vystematizing the nursing on a plan which has been placed 

^^ ^^' Respectfully submitted, 

IsABELLE E. Rutty, 

Sister-in-Charge. 

Miss Shaw, a young Bcllevne trained nurse who had applied 
at tlio Rod CroBs Hospital, was included in this group and her 
r€v<illt*ctioa& art) lively enough to deserve more space than we 
can ^vo them. She said of the stay in Tampa: 

Typhoid fever was raging there and the nurses wished to 
care for the sick men, but there was great difliculty in getting 



34 HISTORY OF AMERICAN RED CROSS NURSING 

permission to do tliiti, al^ tliere seemed to be no organization. 
One never knew what would bet-ome of one next. All one's 
eenice seemed haphazard. 

Miss Shaw told how the nurses were repeatedly transferred 
from one location to another, "always obeying the last order, 
no matter how eoniiictiug with the preceding one." 

Her recolloetion was that an eu^ne<^ring coq>3 was about 
to leave for Cuba on tht> Lam j hi an, "i and that the ivurses, on their 
own motitni, persuaded the captain to take them also. To gain 
hia consent they had to agree to relinquish temporarily the 
protection of the Red Cross and accept all the hazards of war 
on a war ship sailing under military orders in hostile waters. 
Wlien they arrived in Santiago Harbor, the sailors on the ships 
in the harbor turned spy-glasses on them and shouted ^'SkirtsT' 

This picturesque but somewhat adventurous expedition of 
the Lampam^ in the early, chaotic ptTiod of the first war con- 
dnrted by this country since 1HG4, though muck criticized at the 
time, cut a path for later Red Cross nursing service and won 
many friends for nurses. Dr. Charles R. Greenlcaf, Chief 
Surgeon in the Field, wrote: 

The service rendered by the members of this detachment 
of Bed Cross people has been invaluable, and they are entitled 
to great credit for their devotion to duty, their zeal and 
their unremitting care of the sick under circumstances that 
were peculiarly trying. I shall be glad indeed to welcome 
them, should they return, an<I I can always find suitable 
work for them in the base field hospitals.^^ 

Later in the summer Dr. Greenleaf wrote to Dr. Sternberg: 

Porto Rico, August 26th. 
Cabled you to-duy for Miss Rutty and thirty nurses. T 
know her to be a goo<] administrator and valuable woman and 
if she can bring with her the nurses who were on the 
JMmjHiaas I shall be much pleased and you will be sure of 
good service.** 

Witli this episode the immediate connection of Miss Barton's 
staff with war ntirsing ends and no further records arc available 
of the intrL'pid little group of Sisters and Sistcr-in-Chief 
Bettina. A nursing report written by the latter and covering 

"••Conduct of War with Spain," Vol. I, p. 676. 
"Ihitt, Vol. I, p. 603. 



EPISODE OF THE SPANISH-AMERICAN WAR 35 




M Soc 

nop 

■ ^ 

m 

■ t2ie1 
P of tJ 



^\ '• j>t'riod of their service is alluded to in several docu- 

ii lit cannot be found. It must be concluded that it was 

not preserved, an oversight that, from the historical standpoint, 
must be deeply regretted. For some little time Dr. Lesser con- 
tinued to enroll nurses at the Red Cross Hospital, until the 
complete organization of Auxiliary No. 3 centered all Red 
Ctvsa Qursliig activities in its committee. 

A few lilies are needed for the final history of the Red Cross 
Hospital. As the war went on, ita staff was depicted and its 
n>glilar work interfered with, but it kept on in the face of 
difficulties and a certain number of applicants passed through 
it, 6fiTnc of whom made their way directly into the army service, 
while others were listed by the Auxiliary No. 3. After the 

r was over the original Now York Red Cross Society en- 

avored to carry on the hospital according to its first plans. 
In 10O3 a spec^ial corporation was formed to manage it and 
in VJOl the building at 09th Street and Central Park West 
w«« eriHjled and continued for several years as the New York 
Kcd Cross Hospital. Agreements with the National Red Cross 
ftt Washington were made (1003) by which the New York 
Society was to have two members on the hospital board and 
Lospital was to be regarded as an affiliated body under the 

neral jurisdiction of the National Red Cross. It was still 
oped, in some quarters, that the National lied Cross might 
extend the work of developing ita own hospitals for the train- 
ing of Red Cross nurses, but with the gradual abandoiuneut of 
thiA idea, as the greater possibilities were perceived of building 
ap a nursing service by the help of the professional forces 

ready existing, the relationship of the Red Cross Hospital 

the National Committee ceased to have any vital significance, 

and in 1014 this relation was finally severed by mutual consent. 

hospital changed its name and became the Park Hospital. 

At the same time that the Red Cross was organizing for aid, 
t2ie United States Government was preparing an official nursing 
BtalT in the event of war and because of the close relationship 
of the Army Nursing Sennce to the Red Cross, in this as in 
every country, it is important for us to follow here its main 
liiMV. The scope of this work docs not permit a detailed pre- 
sentation of the Army Nurse Corps and its activities at that 
UmCf but compels us to pass over much of interest and value 
tiiat belongs properly to a history of a general, rather than of a 
^>cci8lized kind. 



36 HISTORY OF AMERICAN RED CROSS NURSING 



Ab early as February', 1898, offic^rti of the Government be- 
gan to receive applications from women who wished to serve 
as nurses during the approaching war and all those letters 
and papers found their way to tlie lUea of the Surgeon 
Generals of the Army and Navy. 

So wrote the medical woman who became the official head 
of the trained nurses employed by tlie government in Army 
nursing during the war with Spain, and whose nursing staff 
developed into the Army Nurse Corps. 

Anita Newcomb McGee, M. D., was the daughter of the 
distinguished astronomer, Simon Newcomb, and inherited in- 
tellectual powers. Her medical studies were taken in the 
Columbian (now George Washington) and Johns Hopkins 
Universities. 

She was a woman of strong personality, attractive in appear- 
ance, small, with dark hair and dark blue-gray eyes, of very 
quick movements and keen, rwpid mental processes. Her social 
and scientific position naturally brought her into close acquaint- 
ance with Washington's notables and before war was declared 
she had conversed with the Surgeon General of the Army, 
General George M. Sternberg, upon tlie use of trained women 
in Army work. It was his purpose if war came, to employ 
women as nurses, but it was Dr. McGee who dwelt iijK>n the 
importance of having them professionally well trained and who 
succeeded in carrying this principle into the ser\'ice. She was 
a Vice President Qenerul of the Daughters of the American 
Revolution and this society at her suggesticm formed a *'Ho8- 
pital Corps Committee" of which she was the chairman, with 
Mrs. Amos Q. Draper and Miss Mary Desha as her chief as- 
sistants. Dr. McGce offered the Government (April 27) the 
services of this committee and the offer was accepted. In July 
at the request of the Surgeon General Congn's.^ had authorized 
the employment of contract nurses **regardles3 of sex." 

Dr. Sternberg's official reports and papers give the following 
iccount of the creation of the Army Nurse Corps and a picture 
>f the deficiencies existing in the pre-war Army nursing system : 

The original purpose of the Medical Deportment was to 
have all the ruirsing and other work of the hospitals, includ- 
ing the clerical nnd riisi>enaary work, done by trained mem- 
bers of the Hospital t'orps; but the Act approved April 22, 
18U8, providing fur temporarily increasing the Military 



» 



EPISODE OF THE SPANISH-AMERICAN WAR 37 

Estat>lishmrnt, failed to iriplude Hospital Corps privates for 
the volunteer regiments. The great majority of the Hospital 
Corps men seourerl by enlistment and transfer had little or 
no proper training as nurses and as a consequence were 
largely inefficient. At the outbreak of the war nursing in 
the Army was done entirely by the men of the HoBpital 
Corps; but the employment of contract nurses, regardless of 
aex, was authorized by C'ougrcRS in March, 1898.*' Before 
the 30th of April ahnoet a thoutiund applications had been 
received from women who wished to serve as nurses but no 
examination of these applirants had been possible. On April 
28 the National Society of the Daughters of the American 
Bovolution offered its services to the Surgeon General of 
the Array in the capacity of an cAamiuing lK)ard for female 
nurses and this offer having been accepted, the following day 
all applications from women were referred to it for examina- 
tion. The status of this organization rendered it peculiarly 
suitable to undertake this work. It has headquarters in 
Washington City and twenty-five thousand members living 
in every state and territory of the Union and as it had no 
affiliations with any hospital or body of nurses it is entirely 
unprejudiced in its judgment. Mrs. Anita Newcomb McGee, 
M. D., a physician in good and regular standing and Vice 
President General, National Society of the Daughters of the 
American Kevolution, was designated as director of the 
Danjfhters of the American Revolution Hospital Corps'* and 
ilaccil in charge of this work. Her statement regarding the 
'incthod of selection is as follows; "In accordance with direc- 
tions from the Surgeon General, only graduate trained nurses 

"The Congressioual authoriKation above mentioned was asked for in 
iril, will iiiitAined in July. Spwial iiuthority ft>r the employment of 
vooken nurses in llie Army lippeArs in Sectinnn I23H, \2:\9, 1277, and 1270, 
Bvriacd Statutefl tif ttie Vnited SUtes, providing corapensatton at forty 
ant* » Uay and une ration. Theue date frum the time of the Civil War 
uwl ms9 tb« outgTuwtli of that war. 

^' -li-n nurwfl were emphned in the Army from the time of the 

i until the SpaniJ^h AnH-rican War. Under date of April 28, 

1;l_. , :.. Sur^'WMt (Jenerul. hy letter to tlie Secretary of War, requested 
— fhoif 11.1 to etnploy by contract kh many nursen, male or female, aa 
flll^t be required during the war with Spain at the rate of thirty dollars 
A awNitfa with a ration. The Secretary gr»nted the authority aaked for 
MBilvr »ift*e of April 30, IftOH. No lejfislution in the premiaea was, how- 
PTW. *" 'Ml l!ie Oeftciency Bill of July 7. 1808. which authorised 

tJW rii ' of three hundred civilian nurses at tliirty dollars a 

■MiUl t .1" rM.-itK. 7l)3). Items for the prty of civilian nurtteu without any 
Ihnitation* of numlKT nr rates of pay appear in the Oeficifncy Appropria- 
UoBB for (hi* Me<lical and Hoapital Department in the Deficiency Acta 
January 5, and March 3, 180» (30 StaU. 778 and 1225). 



38 HISTORY OF AMERICAN RED CROSS NURSING 



wern accepted by the Daughters of the American Revolution 
a8 eligible and they were required to till out blanks like the 
cue appended hereto. In judging a nurse, three points were 
considered: First, professional ability: as evidence of which 
endorsements from physicians were usually submitted. In 
all eases the superintendent of the training school from which 
the nurse graduated was asked for endorsement, and when 
this was refused, the nurse was not accepted. A few women 
physicians in good standing were also ac'cej>ted as nurses. 
Second, character: to establish which the endorsement of a 
Daughter of the American Hevolutioii was requested (though 
never exacted). In lieu of this, the signature of any lady of 
known standing was accepted. Committees of 'Daughters' 
were formed in all large cities and in many small ones and 
rendered admirable service in securing suitable applicants. 
Third, health: as evidence of which a physician's certificate 
was required. Jn certain cases, however, where the need for 
tlie nurse was too urgent to admit of delay and where there 
was no reason to doubt her health, this oertilkate was not 
filed. Originally the nurses were required to be between 
thirty and fifty years of age, but the large umoiber of desirable 
trained nurses who were under thirty caused that limit to 
be disregarded. The evident necessity for and importance of 
the limitation of appointments to trained nurses, waa neglected 
only in the sending of nurses to Santiago. As it was essen- 
tial that they should be immune, it was impossible in all 
caaes to require graduation. The assistance of all organiza- 
tions that desired to recommend nurses was gladly welcomed 
and applicants who ctui formed to the standard were accepted 
without regard to creed. Almost live thousand applications 
were examiucd by my associates and myself and about one- 
fifth of that number were accepted as eligible for appoint- 
ment.'' This arrangement with the Daughters of the Ameri- 
can Revolution continued until September 7, since which 
time Dr. McOee, having been appointed acting assistant sur- 
geon, I'nited States Army, has been on duty in the War 
Department, in charge, under my immediate direction, of 
matters pertaining to female nurses. 

In addition to tlie contract nurses, selected as above stated, 
Mrs. Namah Curtis was, on July 13, sent by direction of the 
Surgeon General, to New Orleans and other cities to secure 
the service of colored immune women as nurses at Santiago, 
and thirty-two were selected by her. At the camps at Mon- 
tauk and Jacksonville the chief surgeons were authorized 
to contract with nurses who might apply to tliem, and at each 
place a small number were enrolled in this way. The uuxsing 



^ 



EPISODE OF THE SPANISH- AMERICAN WAR 39 

at a few of the Army hospitals has been done by volunteers, 
with whom no contracts were made." 



Though in the quotation above, ^'directions" are attributed 
the 8urgeon Grneral, it was rcully Dr. MfGce who dctined 
the standards and aimed at maintaining them, for she was 
deeply interested in the sueeeas of women nurses in the army. 
Being a woman, she was solicitous for the prestige of women 
ondertakLng a new responsibility and as a professional woman 
herat4f, she was eager to uphold the professional worth and 
dii^nity of the army mirscs. The directions actually given by 
Genera! Sternberg were, that nurses should be chosen from all 
parts of the United States, if practicable, and that 'Apolitical 
puU'' should be entirely ignored. 

In view of the novelty then of trained women nurses in Army 
arrvice it is interesting to know how Dr. McGee arrived at her 
decisions in selecting her n\irse corps. Although the first 
printed regulations did not qualify the words *'a training school 
for nurses," yet in fact the best known institutions were always 
first applied to. In listing them, Dr. !N[cGce consulted Jane 
Hodsou^s book "How to Become a Trained Nurse," and advised 
writh Georgia M. Nevins (then head of the Garfield Hospital, 
Washington), Isal»el ^Iclsaac, superintendent of the largest 
training school in the West, the Illinois Training School for 
Xursea, Chicago, Sophia F. Palmer, then chaimuin of the 
Daughters of the American Revolution committee in Roches- 

•• ••Conduct of the War with Spnin,*' Reply of the Surgeon neneral to the 
Oenmitttv. The Set(!>ction of Finale Nurses. Vol. I, pp. 725-726. 
TImt question blank sent to nuraee was as follows: 

Xase in full. 

hAAntm and nearest telegraph station. 

D6 Tira tie«ire «ppointm.-iit in Army ur Xavy? 

Bow toon after reieivinf; an appointment can you leave home? 

Have you had yellow fever? 

Af> you a grauuati* of a training school for nurse&T 

If »»' what ii4'b(x>l and what year? 

What other hospital e^jterience have you hadT 

H«v* you nitrM'4l cfinti'nufiusly since grntluatiun? 

If ■ ■ ,- \tt^^n your occunalimi? 

have you had in invnlid cookervt 



\^ 



> iMif "Si*."' 



Date anil 



;^ 



laee uf hirtht 
eight ! 



IWor • ' ~ Height ? 

Art you aiogle. married or widowed? 

Arc you atrung and henlthy and hiive you always boen boT 

Ibr* you a tendency to nny difwase? 

flat'e i<m lieen micceaBftilly vaccinated and when? 

What'U your legal residence T 



40 HISTORY OF AMERICAN RED CROSS NURSING 



ter, New York, and other superintending nurses of note. As 
the war went on, periods of great emergency arose, when women 
possessing every cjualification were not avaihible in sufficient 
numbers and at th(tse times, the less well-equipped graduate 
nurses had to be called up*)n. 

The first volunteer offers mado to the Government had come 
from individual women. On the declaration of war these were 
followed by groups, or organized bodies, of which there were 
in all, as Dr. McGee has recorded, no less than eighteen. Among 
the earliest were the National Emergency Association of 
Women Physicians, Surgeons and Nuraea, of Chicago, whose 
president was Gertrude G. Wellington ; the Graduate Nurses' 
Protective Association of New York State through Misa 
Enright; an association of the Connecticut Training Schmtl 
through Mrs. John Kerrigan; the Metropolitan Nurses' Club 
through Mrs. Mary Hatch Willard; St. Barnabas Guild Club 
of Nurses, and many Catholic orders. 

The Associated Alumnie (whose formation has been de- 
scribed) requires special mention, for this lx)dy sul)se<]uently 
became affiliated with the Red Cross and later broadened into 
the American Nurses* Association, in April, 1898, it was in 
session in New York City for its first regular convention after 
organisation had been effected and it there offered its services 
to the Surgeon General, The president was Isabel Hampton 
(Mrs. Hunter) Robb, whose contributions to nursing education 
and to organization are so important and so closely interwoven 
with our history that we must pause here to bring her before 
our readers. Isabel Hampton was a Canadian of English 
parentage, of a fair and stately type of beauty. Her presence 
was both imposing and winning, for a special graciousness and 
ardor shone in her blue eyes and gave her sweet English voice 
a vibrating, electric quality. Alias Hampton had graduated 
fn)m Rellevue when still below the usual age of admission. She 
had held two important hospital positions, first as head of the 
Illinois Training School, then of the Jt»hn8 Hopkins Scht»ol for 
Nurses, which she organized and directed until her marriage. 
She had l>een foremost in advancing nursing education and in 
promoting nursing organization. Marriage did not lessen her 
devotion to her profession and she was, until her death, its 
chief spokesman in it^ various causes and undertakings. Her 
co-officers in the organization at the time of the war were Helena 
Barnard (Johns Hopkins), Mrs. Hawley (Miss Horner from 



I 



EPISODE OF THE SPANISH-AMERICAN WAR 41 

the JTightiTigale School in Engjland), Tamar Healy (Brooklyn 
Citv Hospital) and Jean A. Hopkins (Bellevue). 

Mrs. Robb brought the wnr situation before the couveution 
and the following telegram was sent to Surgeon General Stem- 
\erg: 

The Associated Alumnse of Trained Nurses of the United 
States and Canada^ including two thousand graduates of 
twenty-four truiiting schools, oflPer their services for any work 
which the Medical Department of the Army may demand of 
them in connection with the war with Sjmin. 

By direction of the delegates now in session in New York 
City, 

(signed) Isabel Hampton Robb, President. 

By an error in transmission the word "nurses" was written 
*^*mu8ic" and Mrs. Robb's name was misspelled. The reply 
receired was the usual courteous form of declining with thanks. 
As B result of this misunderstanding the convention took no 
further action, for the time of its adjournment had come, and 
thereafter its members entered tlie war service as individuals, 
many through the War Department, and others through the 
Red Cross Auxiliary No. 3, Mrs. Robb, however, went to 
Waahingtou and saw Dr. Steml)erg and Dr. McGee. They 
wamily welcomed the offer of cooiK'ration, but a definite mutual 
■^rt^ment was not finally arrived at, because of different points 
of view as to methods. Mrs. Robb, with her intimate knowl- 
edge of training 8cb«M>ls and iHirsf»s, would have urged a some- 
iHiat exclusive standard of requirements, which Dr. McGoe, 
from her more extensive acquaintance with the War Depart- 
mrnt's probable needs and what it would do officially, could 
not promise. The Government's plans were already formulated 
and well under way. 

On May 10, 1808, contracts were signed with tlie first group 
of nix Army nurses. Fn>ni this date, then, one may informally 
reckon the beginning of the present Army Nurse Corps, while 
tti purely official date will be met with a little later. Two of 
the six were inununes, cboacn by the Surgeon General, and 
with whom Dr. McGee had nothing to do. The other four 
were: Johnetta B, Sanger and M. Agnes Lease, both of the 
Johns Hopkins; Alice P. Lyon of the Brooklyn Homeopathic; 
t&d Margaret E. Schaffer of the Philadelphia Hospital." 

•Army Nur*e Corps Index, Surgeon General's oflSw, A. N. C. Dlv, 



42 HISTORY OF AMERICAN RED CROSS NURSING 



They were selected by Dr. McGh?e for Key West but were no< 
Bent there immediately. 

The relation of the nurses to the Government and Dr. Mc- 
Gee, during the time of her work as Direetor of the D. A. R. 
Hospital Corps, is indicated below. The excerpt given also 
shows how the formal appointment of Dr. McGee to an array 
position on August 28, 1898, was made. This began the official 
existence of the Army Nurse Corps : 

Durinj^ the sununer nil applications from women, whether 
addreseed to the I'resitlent, the Secretaries of War and Na^y, 
or the respective Surgeon Generals, were sent to us for 
examination and reply. We were, tiiereforcj more closely 
associated with tlie Government tlmn any other volunteer 
organization; hut, on the other handj the limits of our re- 
sponsibility lm»l always lieen sliarply delinod by the Surgeon 
General of the Army. We had no official relations or com- 
munications with the surgeons, and our official connection 
mth a nurse ceased absolutely when she, having been 
accepted^ sigthcd the army contract. But when a large 
bo<ly of nurses had entered the service many questions arose, 
nece-ssitating ofticiai action in the Surgeon Generars office, 
such as the rccei]ft of reports from surgeons an<3 ordering of 
tran*ifers between honpitals. As I was the person linving 
the greatest knowledge of this work, and as it was impossible 
for a volunteer to con<luct it, the Surgeon tJcncr^l appointed 
me as acting aesiet^nt surgeon. He then believed that the 
contracting with fresh nur&cs was about at an end, aud there 
fore, on September 7 the Daughters of the American Revolu 
tion were relieved., with thanks, from further duty in con* 
ncction with this office. Since that time I have been on 
duty in the War Department, my orders immediately on ap- 
pointment having been to New York and Montauk.^° 



The nurses who signed contracts with the Government were 
claeeod as Uie '*Nurse Corps (female)," with Acting Assistant 
Surgeon Anita Newcomb McGee as their superintendent. 
These titles wore used officially by Dr. Sternberg in his reports 
of that time to the War Department, but in signing papers Dr. 
McGee wrote herself "In charge, Army Nurse Corps." The 
Corps was classified as consisting of chief nurses, nurses and 
reserve nurses. After they eutertnl the Army the title 



1 



••Dr. McOee's teitimony, "Conduct of War with SpaiD," Vol. VII, p. 
3173. 



EPISODE OF THE SPANISH-AMERICAN WAR 43 

•^urws*' fV>rni<>rly applied to the enlisted men on ward duty, 
was rwtricted to the women. The regiihitions governing their 
appointment and defining their duties, pay and privileges, were 
tasued from the Surgeon GeneraTs ottice. 

After June 20, 1808, the printed regulations spetnfied "two 
rMirs reaideuee in hospital training schoor* for upplieants to 
the Army Nurse Corps, thus detinlng what had Iwen the aetiu»l 
practice. In the late summer, with the calls for the typhoid 
cunpaf the rules had to he sometimes relaxed and nurses were 
Acn acwptod from small or special hospitals. There were also 
four large camps where, during the heaviest emergency, the 
Ak'( surgeons had been authorized to secure women nurses 
without regard to training. This method did not commend 
itwlf as one to be approved. 

In round numbers the nurses in service were listed as fol- 
hwB: 

September, 1898 1,200 

Decenib*?r 30, 1898 08G 

July 1, 1809 202 

Total serving to July 1, 1899 1,563 

Number of applicants 6,000 

Fatalities: Trnined nurses 5 

Catholic Sisters {out of 250) 5 

Untraineil (immune) nurses 3 

(out of 100) 
All deaths but two were from typhoid. 

^Aftcr the war was over Dr. MoGce gave interesting testi- 
ly before the Congressional Committee, from which a brief 
ia taken: 

Q. How many of those nurses proved to be thoroughly 
well -trained nurses? 

A. We acroptod only ^aduatos of training schools wlio 
were endorsed by the superintendent of tlieir schools. There- 
fore less than a dozen that we sent were afterwards found 
to be undesirable. 

Q, Did they prove to be eificient in the various hospitals? 

A- Very. We have received very satisfactory reports from 
all hospitaLi. 

Q. 8o far as you kno\v» has the experience in this war 
afaown that female nurses may be properly employed in mili- 
tary bo«piiaJs? 



44i HISTORY OF AMERICAN RED CROSS NURSING 



A, Yes, sir, decidedly so. 

Q. How near to the front have female nurses been sent; 
in other words, how near to the moving column have there 
been female nurses in militury lio^ipitaLs^*' 

A. Female nurses went to Santiago in the middle of July, 

Q. As a result of the exporienoe in ihe mouths j«^t past, 
do you think it advisable that female nurses should be em- 
ployed in military hospitals? 

A. Yes, sir, decidedly. 

Q. Has such opini<in been expressed to you by the authori- 
ties in the Medical Department? 

A. It has been expressed to me by a large number of 
surgeonj^ who have been in Washington. 

Q. The nurses, then, numbering about one thousand, their 
actions being satisfactory to the medical authorities of the 
hospital and satisfactory to the organization that selected 
Uiem, is tiiere any reason, think you, for hesitating to employ 
female nurses in any military hospital other than that in the 
immediate vicinity of the tiring line, where I suppose no 
female nurse can go? 

A. I should judge their presence was extremely desirable, 
as they had a better training than the vast majority of the 
men available for the Hospital Corps. This is the chief 
reason. They were employed in foreign armies and are a 
prmanent part of the British army, where their services have 
been very satisfactory. You spoke in a recent question of 
one thousand nurses. In giving this number I was si>eaking 
only of those accepted by the Daughters of the American 
Revolution- 

Q. To what extent have the religious orders been called 
upon? 

A. To the full extent of their offer. 

Q. Will you tell us what that extent was? 

A, The Sisters of Chanty furnished a few over two 
humlred of their Sisters; the Sisters of Mercy of Baltimore, 
thirteen; the Sisters of the Holy Cross, eleven; the Sisters 
of St Joseph, eleven ; the Congregated American Sisters, 
whu'h c«)nsi8tii of Indian women from South Dakota, hve; 
the Slitters of St. Margaret, which is a Protestant sisterhood, 
two; the St. Barnabas Guild, which is also an Episcopal 
organization, quite a number. We accepted the nurses re- 
gardless of their religious belief if they filed their applica- 
tions in the usual way, and all those Sistt^rs filled out the 
application blanks furnished by the Daughters, and certified 
their qualififations individually and all wore under contract 
and received pay exactly aa Uie other nurses. 



EPISODE OF THE SPANISH-AMERICAN WAR 45 

Q. As to tho^ less than three hundred furnished by the 
vmrious orders, have the reports of them been satisfactory 
to yoa? 

A. Some of the surgeons prefer them to the other nurses 
and some prefer the others, 

Q. To what extent have female nurses been employed in 
diet kitchens in the various hospital, either as superin- 
tcodeuls or oct;u]>ied in the work of the diet kitchen? 

A. They have been employed in a considerable number 

I of hospitals in charge of diet work. I have had several calls 
lately for women to supervise that work. 
y. Have the reixirtit that you have received from the diet 
DOrses of tliof^e oirupied in the care of the diet kitchens 
been satisfactory to you? 
A. Yes." 
I 



iDi the routine of assigning nuTfies Dr. McQee said: 

The original procedure was, when the Surgeon General 
re«'eived requests from surgeons for nurses, he sent over to 
me representing the Daughters of the American Revolution, 
with my associates, for a certain number of nurses to go to a 
certain place. 1 and my associates selected the number and 
0ml tlie names and addresses to him. His clerks then made 
out the contracts and mailed them to each nurse with a 
tranB|Kirtati<>n order. She then went to the hospital to which 
ahe was ordered/* 

■-■■uru 



» 



Dr. McGee*8 testimony also makes clear in an interc8tin|^ 
WRj the record of tlu' uuthi^r and throws liglit on complaints 
that werp numcrotis at that time, of undesirable and unsuitable 
womra who i^ntered in irregular ways through individual heads 
(ftcampa; but it is ntHxllcss to enter into these minutiffi. 

Sorgwn General Stomborg should be more than a name to 
Burwv* and our r<»ader8 may be referred to his biography for 
thi of his 11 fc.*^ His recognition of women in their 

pTj: .^. ...A capacity was very striking indeed, in comparison 
witii the general military reluctance of that time to admit 
vtMDCO into war nursing, and the more so, as his own long Army 
tnining had made him conservative and averse to innovation. 
Be had little knowledge of what women could do aud at first 



•* of Ihe Wur with Rp«in 

•. ;i 173-3174, 

""A Biugmpby of George MiUer Sternberg, 



Vol. 7, pp. 3168-3180. 

by Martha L. 8t«rnbergr. -' 



46 HISTORY OF AMERICAN RKD CROSS NURSIXG 

anticipated placing them only in base hospitals. He appeared 
an austere man, not easily approached nor readily persuaded. 
He was entirely free from political opportunism. "Pull" -was 
odious to him and this was of the greatest importance to the 
nursing service. After the war, Dr. McGee said of him: 

The Surgeon General had of his own initiative and without 
suggestion from anyone ahked from Congress and received 
an appropriation for the payment of contract nurses, either 
male or female. Had he not done this, the Nurse Corps 
could have had no existence, and »o it should never be for- 
gotten that however much tlie Surgeon Oeneral may have 
been assisted by others, the first and fundamental action to- 
wards the recognition of women nurses in the army was 
taken by Surgeon General Sternberg. 

The work that Dr. McGee herself did w^as pioneer effort of 
an original and difficult kind and in its execution she commands 
tne appreciation and recognition of the nursing body for break- 
ing the ice of military routine and opposition to women nurses 
in the Army and for the care and regard she had for good pro- 
fessional standards. She Iwre the brunt of heavy initial respon- 
sibilities and difhculties, with the usual criticism that piuneers 
meet, and so made it easier for those who followed her. Many 
nurses of the finest quality first entered the war nursing through 
her office, women who be<'ame distinguished and who still liold 
important places in the Army, Navy and Red Cross services. 
She was staunch and loyal to thcm« fair, kind and helpful in 
her personal relations with them and bad their strong regard.^ 
One who knew her said of her: 

Her friends were devoted to her; those who were hostile 
were equally strong in their feelings. Her ability as an 
organizer was ronsideralde; her ability to rarry her point was 
remarkable; she kept in touch with her chief nurses, writing 
often to them. She had great influence with prominent 

"In the winter of 1809-99, Dr. McGoe and the tncmhors of tho Army 
Nurse Corps founded the Society of Spanish-American War Nurw^, and 
Dr. McGee wan for six yetirB ita prt*»*ident and later its honorary president 
for life. The other ol^eerit in its Hrst years were: vice preHidents. Dr. 
Laura A. Hughea. Mary J. McCloud, ffwbel Jean VVulton. Dr. Isabel Klliut 
Cowman, Annie A. Robhins. Rose Meidclbach. Mary E. Dreyer, Anna 
Elixabeth McEvoy, V«ab«lla B. Watern and KlieuK'th Porteous; recording 
•ecr«tary, Lela Wilson; treasurer and curresponding secretary, Harriet 
Cftmp Lounsbury. 



EPISODE OF THE SPANISH-AMERICAN WAR 47 

politiciaiifi niul all the nurses believed that she bad done 
much to help pass the Army and Navy bills after the war. 

In the autumn of 1900, when the Army reorganization bill, 
to be referred to later with more detail, was in preparation, Dr. 
McGec at the request of the War Department wrote the section 
vhieh made the Nurse Corps, as it had been organized, a 
prrmancnl part of the Army. This marked the end of the 
pioneer work and brought a climax of success, long hoped for, 
to the tirst chapter of the story of the Army Nurse Corps. Dr. 
ilcGee tben tendered her resignation, which took etfect De- 
ocmber 31, 1000, and selected Dita H, Kinney, one of her chief 
DurseBy a^ her successor. 

If, as has been said, the present Red Cross Nursing Service 
was foreshadowed by the Red Cross Hospital Ciimmittec on 
which Sister Bettina sat, it is even more certain that it had an 
adrancc demonstration of a prophetic character in the nursing 
Work of Auxiliary No. '3, known also as the Red Cross Society 
for the Maintenance of Trained Nurses. On the auxiliarv 
were women who had always been familiar with the hospital 
and nursing conditions of New York City, such as Jfrs. James 
Speyer, president of the auxiliary and of the Red Cross Hoa- 
pitul, ilrs. Bayard Cutting, Mrs. George H. Shrady, Mrs. 
William Sheffield Cowles (Theodore Roosevelt's sister) and 
Mt»- I^nman Hull. Two women of exceptional character bore 
the direct n*apon8ibility of the Committee on Nursing. One 
pf them, Mrs. Whitelaw Reid, by her charitable interests was 
already closely identified with the hospital and nursing worlds; 
the other, Mrs. Winthrop Cowdin, had not been in contact with 
naraing matters up to that time. Mrs. Reid, who was also the 
auxiliary's secretary, was the first chainnan of the Committee 
on Nursing. An old friend ^^ who worked intimately with her 
through those days has since written of her: 

Elizabeth ^lilln Reid is an exceptional woman, a possessor 
of large wealth and of long years of social and diplomatic 
experience, especially during the time when her husband, 
Mr. Whitelaw Rcid, was American Minister to France and 
Ambassador to England. She is a woman p:ifted with the 
Tirtnes of simplicity,, of uympathy and of loyalty to her ideals 
and her friends. To any object which commands her interest, 
she has brought practical business ability and understandiog 

^MIm Uabel Boardman. 



48 HISTORY OF AMERICAN RED CROSS NITRSING 

combined with clear vision nnd wholr-heartcd devotion. She 
has given not only of hpr wpulth but of hersolf to the great 
causes for M'hich i^he hiboretl, prominent amonp which have 
been the Anierit-an Hod Cross, the hospitals slie has built and 
aided and the public health uursing service she has done so 
much to support. 

Aiiotlier of the Spaniah-Amorican war workers *^ of the Red 
Croas wrote of Mrs. Cowdin: 

'^j. ^ 'Lena Potter Cowdin, in succeeding to the chairmanphip 
' of the Nursing Committee, brought to it excellent administra- 
tive ability and some executive experience in Civil Service 
Reform work. She had iiad neither previous special interest 
nor experience in nurning matters. She had, though, the 
broad liuman sympatliy of her father^ the lU. Rev. Henry 
Codman Potter, ami very unusual qualities of mind and 
spirit. Hor good mctfiod, superb grasp of problems and power 
to inspire loyalty and enthusiasm in her staff made her a 
rare executive. Personally epirituelle and eager, ahe re- 
sembled, to her friends' eyes, a *'flying Victor}'," 

These women naturally came at once into close touch with 
the leading superintendents of New York City. Foremost 
among the latter was Anna C. Maxwell, at tJie Presbyterian 
Hospital, eminent by reason of her great gifts and abilities, 
her compelling personality, stately presence and uncompromis- 
ing ideals of nursing. Anna Caroline Maxwell was by birth 
a Now York State woman, whose Scotch clcrgA'man father 
endowed her with the strong qualities so notably blended, in 
her character, with a great charity of judgment. She became 
interested iJi nursing and with a "love of difiicult tasks" took 
the course of training in the early days of the Boston City 
Hospital School. Following this she was for a time Matron in 
the New England Hospital for Women and Children; and 
Iat<?r was called to the position of superintendent of niirstfs 
of the training 8chot>l. Montreal General Hospital, an ex- 
Cieedingly difficult taak at which ahe did not remain long. Later 
she was superintendent of nurses in the Massachusetts General 
Hospital for seven years. She was called from there to St 
Luke*a Hospital, New York City, where she reorganized the 
si'hool of nursing and where she remained for three years. Then 
she was invited in 1891 to establish the School of Nursing of the 

"MiBB Laura D. Gill. 



^ 




EPISODE OF THE SPANISH-AMERICAN WAR '49 



H Qur 
H onti 



Presbvteriftii Hospilal, alflo of New York, where she spent 
thirty years, — an iinusiml reeord iu this country, — and where 
fihe built up a school of fine traditions, of international fam^ 
distiDguished for the high charaeter of its training and idt»als. 
She was always deeply interested in the Red Cross and from 
the first an untiring worker in its activities. It may be truly 
nid of Miss Maxwell, that no appeal for help that it was 
poMiblj in her power to give, was ever made to her in 
vain- 

Another of the New York nursing leaders who took an im- 
portant part in the war nursing under Red Cross auspices was 
ilra, Lticy W. Qtiintard, at that time head of the school of St. 
Lake's Hospital. Mrs. Quintard had graduated from tin- 
O'' " 't training school in New Haven in 1890, with spe- 

du: '■.'■ (the "Red Seal" indicative of an excellent record). 
Immediately afterwards she was appointed superintendent of 
nureeA there and remained at the head of her alma mater 
ontiJ November, 1895, when she was called to New York. Mrs. 
ntard had, during the war, one of the most difficult posts, 

X at Camp WikoiT, Long Island, and fulfilled its duties with 
freat tact and ability. After the war she was colled to assist 
in the reorganization of the civil hospitals in Cuba. Later 
Ac devoted herself to the Visitiug Nursing Association in 
Philadelphia, where she died. Mrs. Quintard was exceedingly 
eaniert. gentle, but firm in discipline aud deeply religious. To 
ker, the war work was a cross. 

At tlie New York Hospital was Irene H. Sutliffe, whose 
whole professinnal life was identified with its history. She 
ma trained there, was made Directress of Nurses and only 
left it for the short period of war nursing, imtil the time came 
when flho finally retired from active service. During her many 
of authority there and afterwards, when she went into 
at the New York Nurses' Club, she had a special 
LoM on the affections of her pupils. Of unassuming manner, 
great kindness and sympathetic insight, her profeasional career 
WBB peculiarly one of personal influence. Other New York 
nperintendenta. all women of ability and character and who 
iiiarpd in the responsibilities of that time, though less directlv 
drawn into the war work than the three especially mentioned, 
were Agne« Brennan, at Bellevue; Mary Samuel, at Roosevelt; 
MiBB Rykert, at the Post-Graduate; Katherine Sanborn, at St; 
Vincent's; Mrs. Dean, at Mt Sinai, and Mary S. Gilmour, at 




50 HISTORY OF AMERICAN RED CROSS NURSING 



the Kew York City school. With these nursing leaders the 
women of Auxiliary No, 3 formed a strong alHiinrt\ 

In the early part of the auxiliary's artivitios Dr. McGee 
went to New York to talk ovor with its members the Govern- 
ment's plans, and was later elected an ottieor of the auxiliary. 
The auxiliary agreed to use the application form of the Daugh- 
ters of the American Revolution (afterwards the Government's) 
and to adopt the Army rei]uiremeut of training, while Dr. Mc- 
Gee promised to give official appointments to all the nurses 
recommended by the auxiliary. It was flien arranged that all 
the New York superintendents might direct nurses to enter 
through the auxiliary for war work and thereafter the Wash- 
ington office made no f\irther investigation of the qualificationB 
of nurses thus supplied. 

The work of recruiting nurses for Auxiliary No. 3 was 
organized by Miss Maxwell. An informal committee composed ^J 
of the New York superintendents established correspondence ^H 
with training school heads of prominence elsewhere asking ^^ 
them to choose nurses who should hold themselves in readiness 
for service. Of women thus carefully selected, one hundred 
and fifty at a time were brought to New York and suitably 
housed, there to be in instant readiness if calls came. So un- 
certain and so iinperntivi* were these calls that the reserve 
nurses were, practically, almost prisoners in their rooms, for 
little more than an hour could be allowed between summons 
and departure. KHtherine N. Pierce, head of the Samaritan 
Hospital in Troy, New York, gJive her vacation to start this 
recruiting work and after that it was entrusted to Mary E. 
WadJey, a Bcllevne nurse. Miss Wadley was a New England 
woman of great energj' and resourcefulness. Fair and sunny- 
faced, she was attractive and moat capable. She was already 
Buccessfully conducting a large registry for nurses at East 
42nd Street and the war nursing service was brought in to her 
headquarters. The system was quickly reduced to a smoothly 
running nrntinc. Telegrams from Washington would call for 

so many nurses to go at once to . While Laura D. Gill, 

the auxiliary aide, flew to the station to buy tickets and make 
rescn'ations, Miss Wadley summoned by telephone the wait- 
ing reserves. Immediately when they were ofF, calls went to 
the hospital superintendents on her list to fill up the numbers 
that had l)eon sent out. This method worked exceedingly well. 
It was expensive to maintain the waiting nurses in New York, 




EPISODE OF THE SPANISH-AMERICAN WAR 51 

this wag a pnrt of the work of the auxiliary, whose re- 
wrro unstinted. For speed the auxiliary l)ouglit all 
niilio«d tickets and these funds were reimbursed by the govem- 
ment. 

The Woman's Auxiliary No. 3 had a visiting agent of special 
ability and tact in Maud Cromelien, a nurse from the Massa- 
chuscttj} General Hospital. In the late summer when typhoid 
fcvcr bpcaine epidemic in the camps, reports made by Miss 
Cromelien, who had been sent to the camps to offer the services 
of the Rod Cross, and the powerful influences brought to bear, 
AS a result of these reports, by Mrs. Cowdiu aud Mrs. Reid on 
public officials, finally won out over the Army convictiou that 
wiimen should only 8or\'e in base hospitals, and Auxiliary No. 3 
had the immense satisfaction of supplying trained nurses from 
it< staff for the first time on an organized system to field hospi- 
tals, iliss Cr<.>melien considered that this marked an epoch in 
the hLstory of nursing, as indeed it did. When this important 
work waa undertaken a number of New York superintendents 
w«nt themselves to the camps at the head of nursing staffs. Miss 
Maxwell, who had WTitten many personal appeals to the Sur- 
|peou General to allow nurses to enter the camps, was sent to the 
Sternberg Hospital at Camp Thomas, Chickamauga Park. 
Mias Sutliffe went to Camp Black and Mrs. Quintard to Camp 
Wikoff at Montauk Point. Their reports are full of interest 
but can l»e onl^* briefly quoted. Miss MaxwclFs report, sent 
in to ber Board of Hospital Managers^ follows in part : 

Sternberg U. S. Hospital, 
October 31, 1898. 
To the Board of Managers of 
The Pre8l)ytcrian Iloepital, 
New York City. 

(Sentlemeu : 

On August 1, Mrs. Whitclaw Reid and Mrs. Winthrop 
Cowdin, mcnilters of the American National Red Cross, 
Auxiliary No. 3 for the Maintenunce of Trained Nurses, 
a^'ed if the Conmiittee of our Training School would grant 
me a leave of absence to go to Cliickaniauga Park to cstahlish 
the work of iiuriiing m a Field Hospital at Camp Thomas. 
• « * * 

1 lit once telegraphed to all the leading training schools of 
the country for gratluates and received most cordial and en- 
couraging re&pontietf. . . . The valuable services of Mies 



62 mSTORV OF AMERICAN RED CROSS NURSING 

Frances A. Stooe were secured as assistant superiBtendent 
and we left New York on August 7. 

• « * * 

On August 13 we went to the StembGrg TT. S. Field 
Hospital, to begin the work we had set out to do. This 
hospital . . . was dr^sigued to hold uiio tliuusttuil patients. 
The i*upp]ies were coming in slowly, but for the first patients, 
who uuiniiereLl one hunilrH and Ihirty-six, the only things 
ready for use were the tents and beds. The etipplies that 
were on hand had neither been unpacked nor verified and we 
were helpless to pay the sick sohliern the necessary attention. 
It was impossible to borrow any connidernble number of 
utensils from the neighboring cam[is and lute in t!ie *>vening 
I went to the Quartermaster and told him I should stay 
there all night, or until the supplies were unpacked. Tired 
as wo all were we put our "shoulders to the wheel' and before 
midnight we had given out eutBeient material for tlie night 
and had drawn on our own resources for milk, ice, medicinCj 
brandy, hypodermics, tliermometers, sponges, basins, etc., 
provided by the Red Cross. I was informed that it was a 
military law tiuit the soldier, sick or well, must he on the 
spot before rations can be drawn, hence the supply of food 
did not arrive until the following day. 

As the tents were prepared and supplies provided, more 
patients were admitted; often two hundred in a day. In 
many instances they were brought long distances, driven 
through a broiling sun at midday^ and had to lie in the 
ambulance from two to tliree hours before they could be 
moved to their beds. When you consider that often as many 
as four men were crowded into one ambulance, suffering with 
tJiirst and heat, scarccJy able to move in the cramped and 
narrow space allotted to them it js no wonder tliat many 
sutTered from shock, exhaustion and convulsions, 

I am glad to say tiiat we found some of the ollicers who 
demanded an ambulance and canvas cot for each seriously 
8.ick soldier, but the condition of the majority showed plainly 
how meager had l>een the nourishment and care they had 
received. It was certainly a most harrowing sight to see the 
long narrow cota filled with what had been strong, splendid 
men, hollow-eyed, emaciated, muttering in the delirium of 
fever, wires in which dead flies were inerusted tilled their 
mouths, making swallowing almost impossible. Their bones 
protruding through their skin and bed sores several inches 
deep were not uncommonly found on hips, back« elbows and 
often on the head and ears and it was here that all the 
energies and reiwurces of the trained nurse were called forth 



EPISODE OF THE SPANISH-AMERICAN WAR 53 



in making the lives of ili&se meu less wretched and in re- 
storing them to health, ; i; uu* 

The course of our work was often impeded and made Jif!l- 
ctilt bj such stumbling blocks as sanitation of the most primi- 
tive kind, iusuffiricnt disinfections, water supply and atcom- 
modtttions for washing utensils, irregularity in furnishing 
Uito details of soldiers so tliat our work rould not be done in 
a *x»rjsi*t-iitive way. Ofcamonal lack of medidne, milk, ice 
III <. The dearth of orderlies more than any- 

:i\ _ tppet] the work. Those we had were changed 

too otu^n or were physically incapacitated for work. Add to 
tJiis tlie heat, the dust, the moinhire nud the Hies and you 
have the picture complete. 

I cannot say enough in praise ut the liberality and 

thoughtfuhiesa of the auxiliary of the Red Cross Society in 

fi< lt us with eight dormitories, a bathhouse, store rooms, 

'k. lining room, housekeeper, servants and not only the 

tiei-eb^ilieH but many of tiie luxuries of life. 

The Government sent us one hundred and fifty-two nurses 
and a dietitian. In this number seventy-five training schools 
from all parts of the Union were represented. Several of our 

trsing staff were infected with typhoid fever and one. Miss 
Teenwood, died. The totiil number of patients re*reived be- 

reen August 15 and September 10, the dale on which I left, 
nine hundred and tbirty-sLv. Four hundred and seventy 
furloughed and siA.ty-eight died.^^ 



"rtie good Titirsing and the admirable discipline of the stafF 
nndcr Miss Maxi^'eil completely altered the Army othcers' point 
tit view and l>r. HotT Raid to her: **l wondered when yon came 
what vr^ would do with yo\i. Now I do not know what we 
)ffY>a(d have done withont you," 

Mre, Lounsbery (before her marriage, Harriet Camp), who 
followed Aliss ilaxwell , has written commentaries on the 
nursing staff that may be of interest to Army nursea today. 
Sba had graduated from the Brooklyn Homeopathic Hospital 
and htid hold for six years the position of superintendent of the 
Uaini' •>!. During her stay both hospital and school 

deveJiu ,itly. She was the earliest author of profesaional 

bDoka among her New York contemporaries and wrote on **Nur8- 
ing Ethics" and on "Making Good in Private Duty." After 
her marriugi^ she was a loyal organizer of Red Cross State work 
in We«t Virginia, up to the time when this record was written, 

'In till* file« of Aaxiliary No. 3. 



54 HISTORY OF AMERICAN RED CROSS NURSING 



She bad been married five years when she volunteered in the 
Spanish-American war. She wrote of Chickamauga: 

It is very amusing to remember how ignorant we all were 
of Army ways when we first went into camp. I think I am 
riglit in saying wl* all were iufluciici'd by the purest patriotism 
in going. 1 know it seemed to nie a wonderful thing that my 
country really needed me and I joyfully went, anxious only 
to help. I knew nothing of the beet way of getting into 
Army work. As I httppeued to be in Washington, I went to 
Dr. Mc(iee*s office, signed the contract and was sent off. The 
contracts came for the nurses a few days after I liad arrived 
in camp. Most of the nurses had come from the North and 
Nortliwest and had never heard of any contracts. They did 
not know why they should sign snuh elaborate papers. They 
had come to nurse the soldiers, they were doing their best 
and were very successful. At last they grasped the idea 
tliat the contract only meant that the Government wished 
them to be regidarly recognized as a part of the Army and 
most of them signed. 

The thought that upon their conduct and etficiency then 
and there would be bayed the action of Congress as to whether 
women should or fchoulii not he regularly employed as army 
nurses, be looked upon as part of the Army hospital equip- 
ment, was urged upon them again and again and most of 
tliem seemed to feel this responsibility and governed them- 
selves accordingly. 

It was curious and interesting to see representatives of so 
many training schools working together. There was always 
much pride manifested in one's alma mater and school 
badges were, of course, very much in evidence. Nothing 
would bring a nurse more quickly to a sense of her duty than 
to ask if in her training school she had never been instructed 
as regards this or that. Tlie different uniforms were also 
interesting; most of them were blue, blue and white stripes, 
chci-ks. plaid, plain blue, but pink was not absent. There 
were with us nurses from ninety-one different schools and but 
two wore pink. The caps were as diverse as the uniforms. 
Every kind was to be seen, from a tiny square of lawn to 
quite an imposing erection of starched linen and quilled 
ruffles. It seemeil to me that the dainty "Red Cross" cap 
furnished by Auxiliary No. 3 was the most universally be- 



comjng 



34 



""Reminisceneea of Sternberg Hospital," Amtricon Journal of Surtmfft 
KoVtniUr, IU02. 




EPISODE OF THE SPANISH-AMERICAN WAR 65 

The text of the official report of Auxiliary No. 3, as filed after 
the war in the Red Cross records, shows very clearly the char- 
acteristic quality of Red Cross org^aiiization. It did not wait 
to be asked, but pushed forward lookiug for work and reiterated 
its offers until they were accepttni. There is a very important 
differeixce here between the official etiquette of a military hier- 
archy and the informality of a civilian body. The former is 
efiaeatinl for its purpose, but may l>e curried to extremes. The 
latter may be at times inconvenient, but there is in it a life-sav- 
ing power that is precious. The report of the auxiliary is not 
longf but can only hv> quoted here in brief, omitting much inter- 
v^Btin^ material, some of which has already been used, and 
touching only the few outstanding lines: 



REPORT OF AUXILIARY NO. 3, March 1, 1899 

Shortly after the organization of the Society, the president 
appointed a Committee on Xurses consisting of Mrs. White- 
law Rcid, chairman, and Mrs. \V. Lannmn Bull, to select 
nurses and arrange for their transportation and to make all 
final decisions as to the relations of the Society with the 
Government in respect to nurses. On July 21, Mrs. Winthrop 
Cowdin wa« added to this committee. With the abandon- 
ment of the plan for the hospital ship, the scope of the 
Society's work was much enlarged, as it was then decided 
to place trained women nurses in the Army hospitals. It was 
not possible to follow the Ked Cross rule of volunteer service. 
Competent trained women nurses were unable in most cases 
to work without salary, many having others dependent upon 
them for support; but they all gave evidence of patriotism in 
being willing to serve for much less than they would ordi- 
narily receive - . . when the first call came from Santiago 
oa June 30, the committee was ready to respond. 

The first party of nurses sent by the Society went to Tampa 
a few days later under the charge of Miss Laura D. Gill. It 
consisted of twelve trained nurses, one immune nurse and one 
asaistant. A second and third detachment followed, con- 
sisting of five physicians, forty-three nurses and six orderlies. 
[This was the Ijampasajt party already described, sent in 
answer to Dr. Lesser's and Dr. La Garde's request. Its 
Tanderings have already been told.] 

The following letter from Colonel Charles R. Greenleaf 
will show how efficient were the services of these nurses and 
how much appreciated: 



or AMSMSCAS UEX^ 



yUBSKG 





Vfm] 



ere tfiD 

to dstr. It is a 

faOy nsnaaft if tfe 
pkeed dace Mff m 
it k vwMDeasij for mt to a^j 
IL Wkin^ jw aad fte 
I npreaeot trrty tmas K m mad lw|iiA if vf 

tfaal I msj Ke job ^^ub j1 tkis port. I ai^] 



<iiSMd> 




fl. 
Clucf 



of t2i9 Anay. 



A« w» note nrnv vere able to £9 to Cbb* ca 
Ifar ov^nttk «r tfe 5«ftov fpw tkert, the 

inMrnMi. Ae SooFty Mt Out Um 
f«T good Danes ia ovr beme caa^ attd Arny b 
pittb. The sppemaoe of tjpboid sod odwr fcvos vu 
ffwi^Vn and mej i ti c t inmg in tin dtffettBt m^iiiatol and' 
d Jt i iki u boepitok, tiut dse orderlies vetv aiaWf to give ad»-J 
ante icrrire, wt^tk to addftioii mmj n ~ 
Dfou^t DOtBe xTDiB OwM QB tite sifleRsiC txmcpovte. It 
deemed nrrnmnrj tberefSore to g«t ioto doeer nlrttoMe witkl 
tbe Girtei'iifDenf, is order that oor n ws nije^ be eceeptodj 
in (bete bonntaifi. 0& Julr 15 a Speckl 
aouiatiar of Hn. Wbitekv Reid, Mm Wmtbrep Govdmi 
•ad Xr. Hovard Tovmeod, vas sent to Wafhiogton to oaaferj 
viib the aotborities oo tbie rattter. PrceideDt McKinWyi 
eonnderatefy gmited Ibe eoanmittee an imBicdnte mterfiefir 
aad Tcry kiadij arranged a eonfetenoe at tbe Wbito Hooae^ 



KPlSOD£ OF THE SPANISH-AMERICAN WAR 57 



with the Secretary of War and the Surgeon Oeneral. At this 
conference, the committee was assure*! of the cobperation 
of the Government, General Sternberg agreed to meet the 
ladies again in New York the nejit day; at thia meeting re- 
sults were reached which were stated in a letter from General 
Sternberg to Mrs. Keid as follows: 

'*! take pleasure in confirming- by letter the arrangements 
made at our internew in New York on the 17th instant. I 
am quite willing to employ female nurses vouched for by 
yourself as Secretary of the Red Cross Society for Mainte- 
nance of Trained Nurses. I had previously made very satis- 
factory arrangements for the cmpl(j.yn»ent of trained female 
nurses through a committoe of the Daughters of the Revolu- 
tion. As I said to you during our interview, I recognize the 
value of trained female nurses in general hospitals and we 
expect to make use of their service to such an extent as 
seema to be desirable. But 1 do not approve of sending female 
DurseB with troops in the field, or to camps of instruction. 
It is the intention to transfer the seriously sick men from 
our field hospitals to the general hospitals as soou as prac- 
ticable; and we wisli our enlisted men of the Hospital Corps 
to take care of the sick in the Division Field Hospitals and 
in camps of instruction, so that they jnay be fully prepared 
to perform the same duties when the troops are in active 
operation. 

Among these privates of the Hospital Corps who constitute 
the Red Cross organization of the regular military service 
and who are nou-combatanttJ in accordance with the terms of 
the Geneva Convention, we have nmny medical students and 
even graduatea in medicine. I have made an exception with 
reference to sending female nurses to Cuba, in view of the out- 
break of yellow fever at Santiago, and I am now sending 
immune nurses, both male and female, for duty at the yellow 
fever hospitals. In accordance witJi our agreement, you are 
aothori/ed to send ten female trained nurses, selected by 
jfourself, to the Leiter Hospital at Camp Thomas, Georgia; 
ten to the United States General Hospital at Fort Monroe, 
Virmnia, and two to the hospital at Fort Wadsworth, New 
Yonc, the understanding being that those at Fort Monroe ai»d 
at Fort Wadsworth shall be boarded and lodged outside of 
the hospital. 

Thanking you very sincerely for yuur earnest e^orta ia be- 
half of our sick and wounded soldiers, I am, " '" ''" 

Yours very truly, 

George M. Sternbebo. 



68 HISTORY OF AMERICAN RED CROSS NURSING 

A second letter encloBed the following request from 
Charleston : 

To the Surgeon General, U. S. A., 
Washington, D. C. 

I would recommend Uiat twenty nurses be ordered to this 
station for duty in St. Francis Xavier's and eity hospitals. 
Impossible for hospitals to obtain sufficient help. 
Clayton Parkiiill, 

Major and Chief Surgeon, U. S. A. 
First Division, First Corps. 



Tn answer to this last order, t^^'enty nurses went to 
Charleston, South Carolina, on July 24, under Miss Martha 
L. Draper who showed great ability in arranging for the 
nurses and seeing thera started in their work in the different 
hospitals, which were very much overcrowded. 

In addition to this, three men nurses, graduates of the 
Mills Training School " at Bellevue. were sent to the Marine 
Hospital at Staten Island ; and Miss Marjorie Ilenshall went 
with three women nurses to the Post Hospital at Fort Wads- 
worth. Additional nurses were sent to Fort Wndsworth as 
the need became greater, till their number finally increased 
to forty-one, and Miss Henshall had two hospitals under her 
care. In recognition of her admirable work she was chosen 
as the head of the party of nurses afterward sent to Manila. 

The rest of the nurses left at Tampa awaiting orders were 
now sent to the I.^iter Hospital, near Chattanooga, and ac- 
complished good work there, though the service was very 
exacting. Misis Maud Cromclien was sent to inspect their 
work and reported that Major Carter, the surgeon in charge, 
said that "the nurses were indispensable to him." While 
there she visited Ciiirkamauga Park to examine the Division 
Hospitals at Camp George H. Thomas and reported as fol- 
lows: "One glance was enough to convince me that trained 
nurses were greatly needed to care for the sick, most of 
whom were suffering from typhoid fever. The majority of 
patients were in a wretched cijndition and needed skilled nurs- 
ing to give them even a chance to recover. I called upon 
ColonelJ. V. R. Hoff, Chief Surgeon in the Field, and stated 
to him that *the Red Cross is ready to put nurses in at least 

"Thp Kchnol fnr training Tnrn as nurftcft. thon hougpil in s 6ne buildlnf; 
g\\vn to EU'tlr^'Ut' by Mr. D. O. Mille, Mrit. Roid'a father, haa since been 
uiaentitinued. 



J 



EPISODE OF THE SPANISH-AMERICAN WAR 69 

one division hospital; to erect the teutH needed for nurses 
luid to defray all expenses, such as provisious, etc., and to 
provide theiu with a competent matron ; and all to be subject 
to whatever orders or dii^oipline the surgeon in charge ad- 
ises.' At first it was not considered wise to expose women 
the liardbhips of life in a field hospitah However, in tlie 
the exigencies of the situation prevailed and Colonel Hoff 
kind ei]oug[i to recommend my statement to General 
Sternberg, Surgeon General of the Army." 

The following letter from Major R. E. GriflBn, Surgeon in 
(Charge, to Mrs. Reid is a titatemotit as to the work done by 
te Red Cross nurses at Chickamauga: 

"Dear Madam: 

The Red Cross Society for the Maintenance of Trained 
Nurses can truly say 'Veni, vidi, vioi,' for without them 
I would have been unable to have stayed the dread disease 
that has been raging in our camp. Their helping hand 
came in the hour of need and the history of the future shall 
record each and every member of the Red Cross Society 
BA the guardian angels of the Sternberg Hospital. My 
:perience of years of hospital work has enabled me to judge 

the abilities of nurses;, and 1 am proud to say that this 
corps of nurses under the excellent supervision of Miss Max- 
well has never before been equalled. 

Afl to the untiring efforts of Miss Cromclien and her suc- 
cess after knocking at the door of the department for days to 
be allowed to admit your Society, words can never express 
the praise due her. Miss Cronielien was here on the ground 
the day I put my tirst tent at the hospital and immediately 
began building pavilions for the nurses. . . " 

Miss Cromclien said: ''The work begun as an experiment 
has proved beyond doubt the ability of women to work as 
trained nurses in the field hospitals and the small amount of 
ticknest? among us certainly shows that we have the physical 
ndurance needed for such work under such peculiarly trying 
circumstances." 

Ten nurses were at first sent to the General Hospital at 
Fortress Monroe in charge of Miss Lida G. Starr, but later 
others followed and at one time the number maintained there 
by the Society was as large as forty-five. Miss Starr re- 
mained at Fortress Monroe until late in January, when she 
was re<*alled to New York to take charge of one of the parties 
of nurses sent to Manila. 



60 HISTORY OF AMERICAN RED CROSS NURSING 



In August when the Government bought the Missouri for 
a hospital ship, trained male nurses were offered to Major 
Arthur, the oflicer-in-c*harge. These men were chiefly selected 
from the Mills Training School and a few with the assistance 
of Dr. Fifciher, of the Presbyterian Hospital. They fully de- 
serves! Major Arthur's commendation and on the second and 
third trips their number was increased to fifteen. 

Much good was also done by our reprenontative at Fort 
Hamilton. There the work was in charge of Miss M. £. 
Wood. 

Soon after the £r8t party of nurses had been sent to 
Fortress Monroe and Leitcr Hospitol, Dr. Anita Newcomb 
McGee, director of the D. A. 1?. Hospital Corps, visited New 
York to consult with the Committee on Nurses as to the 
best mejins of cooperating with tlie (lovernment in regard 
to the distinction l)etwcen Government nur?es and nurses sent 
out by the Society for the Maintenance of Trained Nurses. 
It was agreed that the Society would cooperate with the 
Government in every way and to make everytliing absolutely 
clear, Mrs. Cowdin, for the Committee on Nurses, visited 
Washington. After her consultation with the members of 
the Hospital Corps, a fund of $500 was placed in the hands 
of Mrs, Amos G. Draper, the treasurer, to pay for immediate 
transportation expenses for nurses, as Congresa had not 
appropriated any sum for this purpose. In all $5,425.80 
were so disbursed by the Society, until the Government as- 
sumed all further transportation charges on September 6, It 
was also agreed that the Society would allow the nurses to 
sign Goveniment contracts when so required, the Society to 
pay their mRintenance and transportation in some cases, in 
others only transportation. 

A ileld nearer home was opened at Montauk. By the 
courtesy of the Managers of St. Luke's Hospital, Mrs. Quin- 
tard, their sujwrintendent, was given leave of absence, so 
that she was able to take charge of this department. . . . 

Miss Young represented the Society at the Detention Hos- 
pital at Camp Wikotf, with fifty women under her. . . . 

In all, Mrs. Quintard and Miss Young bad ten thousand 
patients under their care. 

The following is a summary of the nurses, partly or wholly 
maintained by the Society: 

Fort Wadsworth: Forty-one nurses were maintained and 

paid by the Society. 
Charle}»ton : Twenty nurses. 
Leitcr Hospital: Ten nurses. 



4 




EPISODE OF THE SPANISH- AM KHICAN WAR iil 



Governors lelaitd: Six nurses. J 

Tampa: Five uur^es. 

The Conva!eH(t'ut Home for Nurses, Rowayton, Connecti- 
cut: Ono r»tir»e. 

Atlantic Highlanfls: Five nurses and one Rurgeon. 

On hoppital cars: Four aurges. 

Camp BJflck: Salaries and laundry billfs of forty-two nurses 
were paid by the Society ; the (foveninient provided army 
tents and rations. 

Fort Hamilton; Salaries and laundry l>il|p. of twenty-three 
nunH?g were paid by the Society; the Goverument pro- 
vided army it^nts and rations. 

Fortresii Monroe: Sabiries of forty-three nurses were paid 
by the Government; the Society provideil maintenance 
for the^, and salaries and maintenance for two Red 
Cross nurses. '- 

Hospital ship Missouri: Salaries of fifteen men nurses were 
partially paid by the Society; these nurses were main- 
tained by thi" Government. 
Bodloe's Island: One nurse was paid by the Society and re- 
ceived army ratinnB: There was alno one vonnteer Red 
Cross nurse who received army rations. 

Portsmouth: Six men nurses wore paid by the Society. 
They received army rations, but their transportation was 
■ Uteumed by the Society. 

General Hospital, Montank Point: Almost all of the one 
hundred and fifty nurses under Mrs. Quiutard's superin- 
tendence si^^ned the Government contract. Mrs. Quin- 
tard's salary continued to be paid by the Society, and 
large supplies of all kinds for the nurses were selected 
by Auxiliary No. 3 and their expenses to Montauk 
paid. 

Sternberg Hospital, Chiekftmauga: Sixty-four nurses sent 
by the Society received Government pay and rations. 
Additional maintenance and supplies for these and for 
ninety-six other nurses ordered there by the Government, 
were funiishe<i by the Society. 

Long li^land City Relief Station: Twenty-nine nurses and 
two siirgeims were paid by tho Society and maintained by 
the Relief Station. 

In the tents, Montauk Station : One nurse was paid by the 
Society and one volunteer nurse was maintained by the 
Relief Committee. 

One nurse wat^ supported in Miss OhanlerV hospital. 

Naftsau Hospital and Annex, Hempstead : Twenty nurses 
were paid by the Society and maintained by the HospitaL 



62 HISTORY OF AMERICAN RED CROSS NIHSING 



Home for Convalescent Soldiera, Sag Harbor: Six nurses 
were paiii by the Society and maititained by the citizens 
of Sag Harbor. 

Convaleecent Home for the 8th Regiment at Hunter's 
Island: Two nurses were paid by the Society and main- 
tained by funds raised by Miss Chauncey. 

U. S. Transport LamiHrnajt: of the twenty-nine nurses on 
thii^ transport, many were volunteers, and the salaries 
of some and maintenance of all were borne by the 
Society. 

Nurses were also supplied on emergency calls to the Eighth 
and Ninth Regiment armories. . . . 

With the necessity of reinforcing our troops in the Philip- 
pines came a new opiwrtnnity which the Society was glad to 
grasp. Knowing that General Otis had aeked for nurses for 
Manila and hearing that they were greatly needed there, the 
Executive Committee decided to apply the funds remaining 
in the treasury for this purpose and after a consultation be- 
tween Mrs. Keifl and Secretary Alger, the BUgjtfestiou of send- 
ing nuri^es to the Philippines was favorably received by the 
Government. Wliile awaiting tlie otlicial orders from Wash- 
ington, a Committee on Nurses wae appointed by the Presi- 
dent, consisting of Mrs. Whitelaw l{ei<l, chairman; Mrs. 
Wilham S. Cowles, Mrs. Charles B. Alexander, Mrs. Ednnuid 
L. Baylies and Mrs. James Speyer, ex-ofticio. A formal offer 
waa made by tlie Society to send nurses to the Philippines, 
and on January 8 the following letter from Adjutant (jeneral 
Corbin was received by the chairman : . . . 

"We have determinned to take three transports from here 
to Manila, about eighteen hundred men on eacli. The Secre- 
tary of War approves your sending four nurses on each. The 
first ship will leave the 15th, the other two before Feb- 
ruar)* 1." . . . 

No time was lost in completing arrangements which had 
already been carefully planjied, so that though for the first 
party the notice was Bhort, it was possible to send the 
nurses properly equipi>ed and provided for. The latter were 
most carefully selected, many of them having already done 
valuable work for the Society during the past summer. They 
were personally in.'^tructed in every case by members of the 
rommiltee, as to their duties. The transport was inspected 
by the chairman and her committee, letters of introduction 
from prominent men were secured for tlie nurses and everj'- 
thing possible was done for their comfort and success on the 
expedition. All signed contracts with the Society for sijt 



J 



EPISODE OF THE SPANISH-AMERICAN WAR 63 

roonths' duty in Manila and on the transports to take care 
of the sick in the hoBpital. 

Miss Ilenshal] sailed on the Qrant January 19, with Miss 
Dowling, Miss Tovne and Miss Ridley. Miss Henshall was 
not only in charge of this division but was the superintendent 
of the entire party of twelve nurses. Miss Starr sailed on 
the Sherman, February 2, in charge of the second detachment, 
taking with her Miss Betts. Miss Sara Shaw and Miss Agnes 
Shaw. The last transport, the Sheridan, left February 19 
with Miss Uladwin in charge of the party of nurseSj who 
were Mies Stirk, Miss Mount and Miss Holmes. ^^ 

Tbe report of the committee, with the financial statement 
for which Airs. Speyer justly deserved especial credit, was 
oordially commended by President McKinley in letters to Mrs, 
Speyer in April, 1899, 

Axnong the names mentioned in the Report are those of 
Berend volunteer aides of special ability and usefulness, and 
two, whose work began with tbe lAimpaaas expedition, not only 
Aooompliahed excellent things in the general field of auxiliary 
wrvice but commanded the special regard of nurses for the 
strong influence they lent in support of the professional nursing 
staff. 

One of the first women to regiater at the Red Cross Hospital 

'American Kational Rpd Crws Relief Omimittee Reports, pp. 41-50. 

Tlic contract iiigned hy nurses in tlie Philippines rnn as follows: 

THIS CONTRACT, entered into this duy of ISOfl, 

ai Nrv Vwk City, in the State of New York, between the Red Croas 
Socictjr for Maintenance of Trained NurHea AuxiUary No. 3, and Miaa 

of in the State of witnos»eth : 

Tkat for the conflideration hereinafter mentioned, tho said Miss 

■romiae* and agrees to perform the duties of Nurue on United Statea 
Trmnsporta, or in the Philippinea. Xho minimum term of service shall 
lie aiz moBtha in the IMiilippines in addition to the time of tranHportation* 
■alMft otherwise determined liy tlie Military Commander, or hy the Red. 
Cr«iM 8<.iciety for Maintenance of Trained Nurses Auxiliary No. 3, aa 
i qimt nted by the Superintendent of Nurnes. The said Ri-d Cross Society 
lor MainteDance of Trained Nurses Auxiliary No. 3 proraiaea and agreea 

t0 pay, or cause to be paid to the said Miss the sum of 

$80 per moBth, and to furnish Maintenance, Laundry, Medical Attendance 
tiurin g bcr term of service, and the assurance of means for a suitable 
rctiirtt home. 

AND IT IS FURTHERMORE AGREED that the said Miss 

Aall re-coiTe transportation while on duty, and on departure from and 
rcttini to ber place of legal residence, from the Government. She shall 
•gr^» to mro^iize the authority of the Superintendent of Nurses appointed 
hj the Atixlltary. 

Misa 

Signed, sealed and delivered in the preacnce of 



^ HISTORY OF AMERICAN RED CROSS NURSING 



for executive service was Laura Drake Gill, a daughter of the 
New Enghiud Pilgrims and Puritaus. She was a college 
woman of broad training and was placed in general charge of 
the Lampasas party by Mr. WardwelL Later, she was sent to 
Chickamaiiga to place the nurses in the Leiter Hospital and at 
all other times, had charge of all the transportation of nurses to 
and from K'ew York, meeting and dispatching them by day or 

, Another prominent aide was Margaret Livingston Chanler, 
of Knicki'rbockcr circles, who after the war, married RicL- 
ard Aldrich. Both of these aides gave strong suppurt to the 
post-war campaign of placing nurses permanently in army hoa- 
pitals, 

. Our space allows no full detail of the many nurses who de- 
serve mention for their part in the Spanish-American War epi- 
sode, but a few names must be taken from the Army Nurse 
^orps Index. Some of these became distinguished in other 
ways later on. Not a few reappeared in subsequent Army and 
'!Nav^ nursing and lied Cross org»ni2ation. Two members of 
the Lampasas party, Beatrice Von ITomrigh and Mary E. Glad- 
win, will be met more than once in later pages. 

Esther V. Hasson» who served in 1S98 on the Belief, became 
Superintendent of the Navy Nurse Corps (1908) and Dita 
Kinney, as already told, of the Army Nurse Corps, 

There were women of eminent distinction in training school 
work then and later, — among them Nancy Cadmus, whose 
administrative career in hospitals was unbroken for years, 
€»jccept for the war service; Frau<'e8 A. Stone, associated with 
!Mifla Maxwell at the Presbyterian Hospital and Mrs. Louns- 
bery, with others aln-ady mentioned. 

Especially distinctive was the work of the grrmp of women 
who, after the war, carried out the organization of modem 
training schools in the civil hospitals of Cuba and Porto Rico, 
jXucy Quintard, Sarah S. Henry* M. Eugenie Hibbard, Mary A. 
fO'Donnell, Amy E. Pope and others.'*' Mary J. McCloud 
rorganizod a school in the military hospital at Mexico City., 
i;iizal>eth Stack taught the hospital corps men nursing and die- 
tetics at Angel Island. On the Army Nurse Corps Index, too, 
one finds Yssabella 0. Waters, whose later compilation of public 
health nursing agencies in the United States, kept yearly up to 
date, has become a classic of its kind; Lydia Holman, one of 

■"lUfttory of Nursing." Vol. UT, Chup. VL 



i 






BPI80DE OF THE SPANISH-AMERICAN WAR 66 

earliest pioncors in niral nnrsiiig; Jane Hodson, Author of 
well-kno^TO book previously mentioned ; Isabel Jean Walton, 
a New York Hospital fturse since then identified with St. 
John's Floating Hospital and other public health nursing work. 

Some of those no longer living tniist be named. Clara L. 
Maas was a young Anuy nurse who during the investigation 
of yellow fever transmission in 11)00-11)01, in Cuba, insisted on 
being allowed to volunteer for the experimental service. She 
ma accordingly bitteu by an infected mosquito and died as a 
fBBnlt of the too-perfect demonstration. ^>hc was buried with 
military honors and is mentioned with respect in several official 
records. Louisa Parsons, English born, and a Spanish- Ameri- 
can war nurse, died in the British Army service in 1915. 
Emma Duensing, Genntin born, died in the same year in the 
lervice of Qerumuy. Tvose Kaplan, who had become head of 
a hospital in Jerusalem, died while caring for refugees in 1917. 
A little group of Spanish-American war nurses lived to serve 
throughout the World War, They were: Samantha C Plum- 
mcr, Edith Kutley, Helen M. Picket, M. Estelle Hine and 
Carrie L. Howard. 

After the war there were many testimonials to the usefulneaa 
of tlie Army nurse. It may suffice to repeat here the conclusion 
reached by the Congressional committee appointed to inquire 
into the conduct of the war. In its report, among other reoom- 
mendations was this one; "... Needed by the Medical De- 
partment in the future; a Reserve Corps of selected trained 
women nurses," ^" 

Its estimate of the nurses ran as follows : 

In the last twenty years the value, the efficiency and the 
arailability of well-trained women nurses has been demon- 
strated and it is much to be regretted that this fact was not 
fully rcahzed by the medical officers of the army when the 
war commenced. It is to be remembered, though, that in 
military hospitals in the field women had been employed as 
Dorses, if at all, only to a very limited extent, and there was 
good reason for questioning whetl»er a field hospital with a 
moving army was any place for a woman. Our recent ex- 
perience njay justly be held to have shown that female nurses, 
properly trained and properly selected, can be duly cared for 
and are of the greatest value. Those who have been serving 
under contract in our military hospitals, and there have been 

■Cooduct oC War with Spain," VoL I, p. 189. 



66 HISTORY OF AMERICAN RED CROSS NURSING 

about fifteen hundred of these, have with scarcely an excep- 
tion done excellent work and it is to the high credit of the 
American soldier that not a single complaint has been made 
by any nurse of personal discourtesy." 

""Conduct of War with Spain," VoL I, p. 171. 



CHAPTER III 



• 



I 



AFTELtATION OF THE AMERICAN RED CKOSS WITH THE NURSEs' 

ASSOCIATION 

Tk€ Army Nurse Corpa^ Reorganization of the Red Cross in 
1905 — The A merican Federation of Aftsociated Alum nw 
Accepts Affiliaiion with the American Red Cross — Develop- 
mint of the Cursing Service — FariicipiUion in Disaster 
Relief 

THE war was not yet over when the idea of securing the 
existence of the Army Nurse C'orpa by legislation was 
agitated by various war workers. In December, 1898, 
Dr. JlcGee went to Now York to suggest to Mrs. Quintard and 
other uuntes with whom she had been in close touch, the wisdom 
of atteinpting such legislation. While she, as a subordinate of 
ifae War Department, could not initiate it, she would, she 
promised, do everything in her power to obtain Congressional 
ttpproval of an act that should not be too great a departure from 
t£o mcUiods and ide^is of the Army. 
At almost the same time Mrs. Robb went to New York to lay 
eimilar proposal before nurses and Auxiliary members, all of 
bcmi received the suggestion with enthusiasm. 
In view of the Army Nurse legislation of 1920, a full account 
tluit first campaign would be interesting, but we must limit 

Ives to a brief summary of its main features, 
A (Hjmmittee of women, many of them of national distinction, 
with prominent nurses, promoted tlie bill. Mrs. Winthrop Cow- 
din was it^ first chairman and among those who, in the course 
of its duration, served on the "Committee to Secure by Act of 
CongresB the Emplo\Tnent of Women Nurses in the Hospital 
Scrrice of the United States Army," were Louisa Lee Schuy- 
ler, THeran of the Sanitary Commission of the Civil War; ifrs. 
William Osbom and Mrs. Joseph Hobson, two of the organizers 
Bellevue School for Nurses; Mrs. Amos G. Draper, 
lit in the Daughters of the American llevolution; Mrs. 
67 




68 fflSTORY OF AMERICAN RED CROSS NURSING 



Whitelaw Reid, unfailingly helpful in nursing matters and 
lavish of her intiuencc and means; Margaret Livingston Chaulcr 
and Laura l>rake Gill, who had been two of the most hardwork- 
ing of the volunteer aides; Mrs. \V. X. Annstrong, of Hampton, 
Virginia; Mrs. Bayard Cutting; !Mrs. C. K. Meredith^ Mrs. 
Harriet Blaine Beale, Mrs. John S. T. Hull, Mrs. Hawley 
^the English nurse, mentioned earlier as Miss Horner and 
afterwards married to Senator Hawley of Connecticut), with 
Anna C. AlaxwoU, Iri'n<' H, Sutlitf»\ Isalx'l Hampton Rohb, 
Ellfn ^I. Woi>d, Linda Uii-hards, M. Adelaide Nutting, Alary 
F. Wadley, Georgia ^L Nevius and Lucy W. Quintard. Misa 
Nuttiug was the chairman of the committee of nurses and 
directed the work of infonniug the rank and lile of the points 
at issue. She was then auperiutendent and principal of the 
Johns Hopkins training school where she had entered as one of 
Miss Hampton's first class and in which she bad risen to the 
position of head of the school on Miss Hampton's marriage. 
Born in Carmda, Miss Nutting's brilliant mind and untiring 
energy' turned witii special attention to t'duciitional nursing 
problems and slin will b*i met in the forefront of such circles of 
activity, as we go through these pages. Her work at the Johns 
Hopkin.<i was so original and etf'ective that she was called tbenoo 
to dirwt tJio Department of Nuri^ing and Health at Teachers 
Collegt^ where she surrounded herself with ardent young cnthu- 
si&gta and made an international reputation for her department 
In the work for the Army Nurso Rill hor executive ability was 
for tlie first time shown outside of the hospital, for there was 
then no nursing journal, no close network of central and local 
associations to facilitate communication. She said^ later: 

One of the things that makes that correspondence sta 

out in tny niemory is the fact that for tlie first time in 
iiig school work I had some help from a stenographer. The 
New York women insisted upon my using such assistance, 
whieh I rather timorously did to a small degree. 

I This was the first time nurses had approached Con 
Miss Nutting wrote: 

One incident which stands out rather clearly was a hearing 
by tlie Military Committee of the House or Senate, I forget 
whicJi, where I had to summon by telegram Mrs. Isabel Robb, 
Miss Mclsaac, Miss Majcwell and various others, including, I 




ft 



I 



REORGANIZATION AND AFFILIATION 69 

think. Dr. Billings, who gave us coiietaut help and odvinc. At 
the beginning of the hearing in Wa^^hington, in walked Mrs. 
Joseph Hobsun, who had heard of it and wanted to give her 
point of view on the imporUuce of good nursing. I remem- 
ber what an ordeal it was, because as chairman I had to intro- 
duce each member and explain who he or she was and why 
his views and opinions would be entitled to respect and 
•when it came to Dr. Welch, who wa^ there and Ppoke splen- 
didly for us, I felt paralyzed. ' 

, Powerful yet intangible opposition to the bill was met with. 
It seemed to be cflpec.ially dirnctod agjiinst tlic profeasiona! 
rvquirements aaked for and tl»c stipulation that the head of the 
Anny Nurse Corps should be a nurse. The committee and the 
ttUire nursing profession back of them regarded tlieee require- 
nwnts and the claim for a nurse superintendent as fiiudamental. 
In the process of overcoming the opposition, Margaret Chanler 
volunteered no less a service than to make a trip to the Philip- 
pineSy to investigate persistent unfriendly rumors that appar- 
ly came from Luzon and were brought to members of Con- 
in depreciation of the morale of women nurses in the 

had indeed been some unfortunate selections made in 
the early part of Philippine war nursing, when western Red 
CroBB societies had unwittingly recommended several women 
of unsuitable type, who had been sent home in disgrace. But 
when Mifis Chanler visited Manila (summer of lSi)9 ) there was 
only the carefully chosen staff of seventy-five nurses sent out by 
the Auxiliary No. 3, working under Colonel Greenleaf, who 
WM their staunch friend. It was clear that the hostility of 
the opposition did not then emanate from Manila, and myster- 
ioudy enou^y with Miss Chanler's visit it was effectually 
ai If need. 

The bill sponsored by the committee was brought up in 
Otm^ress on January 24, 1890, but failed to pass. Resolute in 
their determination, the committee continued their work 
throtkgfa 1900. They had at first asked for a ''Nursing Service 
Commission" and educational requirements alike for the entire 
staff, i.e., "General hospital training of not less than two 
years.'' Thrive years' training was then established in certain 
large schools and was being rapidly extended.. Many nurses, 
too, "were taking postgraduate courses. 

The contest ended in a reasonably satisfactory compromise, 




70 HISTORY OF AMKRICAX RED CROSS NURSING 

for the committee finally agreed to accept a section in the Army 
Reorganizntion Bill of IDOO-lJ^Ol. This was the section pre- 
viously referred to, drafted bv Dr. McGee. at the request 
'of the Snrgpon Genrral, on wliat seemed to the War Depart- 
ment acceptable lines. The committee obtained tlie insertion 
of an amendment to it specifying in part, for the superintend- 
ent, the educational qualifications they had wished to secure 
throughout the staff. Thus amended, Section 19, aa it was 
numbered, read (omitting unessential details) : 

That the Nurse Corps (female) shall consist of one super- 
intendent, who shall be a gradunte of a hospital training 
school having a course of instruction of not less than two 
years, and of as many chief nurses, nurses and reserve 
nurses as may be needed, provided that they nhall bu grad- 
uates of hospital training eehools and shall have passed a 
satisfactory profcssioual, moral, mental and physical examina- 
tion.* 

The bill was signed by the President on February 2, 1901, 
and the nurse sclented by Dr. McQce to be her successor was 
duly appointed. 

Mrs. Dita 11. Kinney, the new head of the Army Nurse 
Corps, had had active service during the war, chiefly in the 
West and Suuthwest. She was a New York State woman, 
trained at the Massachusetts General Hospital (class of 1892.) 
Her experience before the war had been varied and responsible 
and she had carried on some pioneer work in teaching the 
elements of nursing to mothers of families on social settlement 
lines. Mrs. Kinney had earlier shown her courage by making 
the first attack in print on bogus schools for nurses. 

•Army Reorganiisation Act of 1901— February 2, 1901. Sec. 10, Vol. 31, 
U. S. StHtutofl at Lnrpo. p. 748. 

The "Spt'ciHl Cnmniittw in Charoe of the BiU" diirinfi the 56lli Congre«8 
weror Miiw Mnrjfnrct Livinjiston Chanli^r^ Mrn. Harriet BUine Benle, Mra. 
Joseph nolwon, Mra. WiUiiim Sheffield CowIph, Mrn. Joseph K. Hawlcy, 
Mrp. Amo8 O. Driiper, Mrs. John S. T. Hull, Miss GtMir^ria Xevini*, 

TIio Navy Nurse Corps mmhi followed. It whb orpinizcd definitely in 
inOl; the i\r»t effort to p«fw a hill in ConpreRi* waH made in IftO.T; ftnfll 
pnMage of the UiU came in in08. Xnw Appropriation .\ct of Mav 13, 
1908, Vol. 35. V. S. Sttttut4s at Lflrjie. p. 1211. Dr. Mi<iee helpwl in 
framing the Navy Niirm* PorpB Bill nUn nnd tl nuijrh her efTorts various 
approprintion items henefttJn? both nervices were pecnred. Tn view of 
the later liestouHl nf *'f!unk" im Arrriy niiriM*it. it i^ interesting to know 
that Dr. MeOef op«»ned the *iihjeet of rank with the Siirpeon uenernl st 
the time of drftflinp "Soetinn UK" But tlio Ann) attitude then was 
immovably oppoard to any »uch innovation. 



REORGANIZATION AND AFFILIATION 



Tl 



The first few years after tha war were full of rcorgauizntion 
pUna^ both in the Aineriean Ked Cross and in nursing societies. 
The I«»oii8 of the war were not forgotten and women in New 
and elsewhere, who had been at the head of relief and 
ling work* held to the Red Cross, hoping to continue the 
icBl system they had done so much to develop. In that 
iod also, the two nursing societies, the Superintendents' 
iety and the Associated Alumme, had joined in a free 
tatiou for international purpt^ses, under the name The 
'icAu Federation of Nurses, each one retaining its corpor- 
ate identity. 

At a meeting of the Superintendents' Society (October, 
1903). a resolution had been adopted giving its councillors 
powpr tn act for the society in any public question that might 
arise during the ycflr. This action hiid been specifietilly taken 
with a %-iew to future union with the Red Cross, for which they 
dKriafaed a desire. The Associated Alumna; were etjually alive 
to this poasibility, one of the great questions of iliat day^ and a 
QOOcerUtd effort to open up a way of affiliation with the Red 
Ccoas waa made in Uie winter of 1004 by executive officers of 
Uie two societies. The American Journal of Nursijig said in 
April, 1904: 

On February 23, a number of woll-known women in the 
numng profession came together in New York and quite 
informally a group of New York women met with them 
in the evening to discussion questioue of importance to nurses. 
The out-of-town members present were Mary M. Ttiddle, 
president of tlie A£«ociated Alumme; M. Ailelaitle Nutting, 
president of the American Federation of Nurses ; Tsa- 
bel Mclsaar, president of the Ammran Juurruil of NurS' 
mg Company; Sophia F. Palmer, editor of the American 
Journal of Nurtnn/f, and the five Chicago members of the 
daas in Hospital Economics at Teachers College. 

Of tlu' well-known New York women there were present 
Miss Maxwell, ili^s Delano, Miss Wilson of St. Luke's; 
Milts Sanborn of St. Vincent's; Miss Pindell, of the Metro- 
politiin; >frs. Dean, of Mt. Sinai; Miss Gilniour, of the New 
York City eehool; Miss Mary E, Thorntou, secretary of the 
' ' ' . and others. 

.ration of war between Tlussia and Japan 
- question of the position American nurses 
'ime of natinun! or iiiternationftl cftlsniity and 
(hut some action should be takeu that would 




72 HISTORY OF AMERICAN RED CROSS NURSING 



place American nurses always in an attitude of readiness 
wbeu their fiervicee were needed, either at home or abroad. 
In a discussion the following points were brought out : 

1. American nursci:, to be at all tiraen in a position to-' 
render aid to sulTering humanitj-, regardless of nationality" 
or creed, should be affiliated in some way with the American' 
National Red Cross. * 

2. iSnch afliliation should be consummated through 8om6(. 
one of the existing nursing organizations. "11 

An informal committee was appointed to ascertain whethewl 
the American Nutioiia! Hed Cross had so far contemplated*. [ 
its reorj^nization that it roubj consider a proposition for- 
such aHiliatiou if ma^e through the proper of!icial channel. 

r 
Tho editorial added: 

The Society [Red Cross] is now in a condition of re-^| 
organization and this reconstruction period would seem to'' 
be a very proper time for American nurses to endeavor to- 
obtain some form of affiliation which would identify them 
with the lied Cross. j 

>| 
At tliis point Miss Delano reappears in our history for thej 
first time since the yellow fever episode. She had not entered 
the war service, but had remained at her institutional work. 
In 1902-1904 she was at the head of the Bclleviie school. 
There she was in close association with Mrs, Whitelaw Reid — 
whose family had long Ix'cn identified with large gifts to Belle- 
vue and who was one of the Board of Managers — with Mrs. W. 
K. Draper and others who had been members of the Red Cross 
Auxiliary No. 3, Whilst the war activities were going on Miss 
Delano had joined the New York State Red Cross Branch and 
had beeorao deepl.v interested in bringing a large enrollment of 
nurses into it So keen was this interest, even when the war 
was over and reeoustruction not yet begun, that one of her assist- 
ants in tho Bcbooly Mary A. Clarke, wrote later: 

During that period we often discussed the work of the 
American Oed Cross riurj^ep, and even then it seeme<l to me 
tliat of all the nurses in the United States Miss Delano was 
the fine woman capable of taking hold of the nursing service 
and promoting it for greater development. 

From that time on Miss IWano's devotion to the Red Cross 
gradually became paramount with her. 



REORGANIZATION AND AFFILIATION 



73 



next advance toward affiliation was tukon by tLo national 
;ion in 1904. At the AesociiittHi Alumiiic convention of 
tliit year the president, Mary M. Riddle, a Pennsylvania 
woman, trained at the Boston City Hospital, who hud held 
pxccntive positions there and in other MaBsachusetts hospitals 
and Twho had been for years a strong figiire in nnrsing affairs 
and in Red Cross organization in that state, said, in part: 

We have in this countir an organissation known as the 
National Red Cross, with whose name nt least we arc familiar, 
bat whose plans for work we do not always comprehend. 
Our idea would be to ally ourselves with this national body 
for practical purposes. 

So strong was the conviction that nurses should be awake 
to their opportunities and responsibilities in this direction 
that an informal committee vitiilcJ last winter in Washing- 
ton members of the Red Cross Association in high official 
position and placed the matter before them. The suggestions 
of tlie c-ommittee were welcome and it was advised to make 
preparations for the work, with tlie promise that an oppor- 
tunity would be given the nurses for rendering their service 
whenever the demand for such service should arise. . . . 

The appeal is made to you to consider the advisability of 
getting into form for such work. It is made to you because 
you are the rank and file of tlie nursing profession in this 
country and witliout you nothing can be done, upon you 
must the dependence for service be placed. 

don followed and then action: 

The President: I would like to ask if it is yonr pleasure 
to refer any question of alliance with tlie Ited Cross Society 
to the Executive CommitteL' and Board of Directors? 

The Secretary: 1 would like to move that since Miss Riddle 
has already conferred with ladies on the Board of Directors 
of tlie Red Cross Society, she be empowered to associate with 
her two, three or four people whom she knows to be interested 
io the matter and proceed in such manner as the committee 
thus formed may decide. 

Seconded and carried. 

The committee formed comprised Miss Riddle, chairman, 
Miss Maxwell and Miss Darner.* 

The Superintendents' Society then appointed a similar com- 
mtttee with Miss Nutting as chairman, to meet and confer with 
*pTow«dings Atinottl CoaYcntlon of the Aaaociatcd Alamnoe, 1904. 



72 HISTORY OF AMERICAN RED CROSS NURSING 



place American nurses always in an attitude of readiness 
wheji their services were needed, either at home or abroad.. 
In a discussion the following points were brought out: \ 

1, American nurses, to be at all times in a position to- 
render aid to suffering humanity, regardless of nationality 
or creed, should he afliliatcd in some way with the American^ 
National Red Cross. * 

2. Such affiliation should be consummated through some! 
one of the existing nursing organizations. ■ 4 

An informal eomniittee was appointed to ascertain whetterr 
the American National I^ed Cross had so far contemplated, 
its roorganiziitinn that it roiild t'oiinider u proposition for; 
such atliliation if ma\iii IhrougL the proper utticial channel. 

The editorial added: 

The Society [Red Cross] is now in a condition of re-* 
organization and this reoonstrurtinn period would seem to' 
be a very proper time for American nnrses to endeavor to> 
obtain some form of atBliation which would identify themf 
with the Red Cross. y 

At this point Miss Delano reappears in our history for thai 
first time since the yellow fever episode. She had not entered, 
the war service, but had remained at her institutional work- 
in 1902-1904 she was at the head of the Bellevne school. 
There she was in close; association with Mrs. Whitelaw K«id — 
["whose family had long Iwen identified with large gifts to Belle- 
Iviie and who was one of the Board of Managers — with Mrs. W. 
K. Draper and othi^rs who had been members of the Red Cross 
Auxiliary No. 3. Whilst the war activities were going on Miss 
Delano Lad joined the New York State Red Cross Branch and 
ihad become deeply interested in bringing a large enrollment of 
nurses into it. So keen was tLis intenist, even when the war 
was over and reeonatniction not yet begun, that one of her assist- 
ants in the school, Mary A. Clarke, wrote later: 

During that period we often discussed the work of the 
American Red Cross nurKcs, and even then it seemed to me 
that of all the nurses in the United States Miss Delano was 
the one woman capable of taking hold of the nursing service 
4nd promoting it for greater development. 

i From that time on Miss l^lano's devotion to the Hed CrosB 
gradnally became paramount with her. 



REORGANIZATION AND AFFILIATION 73 

nract advam'e toward affiliation was taken hv the national 
mociation in 1904. At the AssociutcHl Ahininse convention of 
Uillt year the president, Mary M. Kiddle, a Pennsylvania 
woman, trained at the Boston City Hospital, who had held 
executive positions there and in other Massachusetts hospitals 
and "who had been for years a strong figure in nursing affairs 
and in Red Cross organisation in that slate, said, in part: 

We have in this eountrv an organization known as the 
National Red Croes, with whose name at least we are familiar, 
but whoee j)Ians for work we do not always comprehend. 
Oor idea would be to ally ourselves with this national body 
for practical purposes. 

80 strong was the conviction that nurses should be awake 
to their opportunities and responsibib'ties in this direction 
that an informnl committer visitpd last winter in Washing- 
ton members of the Red Cross Association in high official 
position and placed the matter before them. The suggestions 
of the committee were welcome and it was advised to make 
preparations for the work, with the promise that an oppor- 
tunity would be given tlic nurwa for rendering their service 
whenever the demand for such sen*ice should arise, . . . 

The appeal is made to you to consider the advisabflity of 
getting into form for such work. It is made to you because 
you are the rank and file of the nursing profession in this 
eountry and without you nothing can be done, upon you 
must the dependence for service be placed. 

Dwnumon followed and then action: 

The President: I would like to ask if it is your pleasure 
to refer any question of alliance with the Red Cross Society 
to the Kxecutive ('ommittee. and Board tif Directors? 

The Secretary: I would like to move that since Miss- Riddle 
has already conferred with ladies on the Board of Directors 
of the Bed Cross Society, she be empowered to associate with 
her two, three or four people whom she knows to be interested 
ill the matter and proceed in such manner as the committee 

lus formed may decide. 

SwHjnded and carried. 

The committee formed comprised Miss Riddle, chairman, 
MiM Maxwell and Miss Darner.* 

The Buperintendonts' Society then appointed a aimilar com- 
mittee with Miss Nutting as chairman, to meet and confer with 
'Fr o ewdingB Annual Convention of the As6oci«t«d Alnmnic, 1904. 



74. HISTORY OF AMERICAN RED CROSS NURSING 

Miss Riddle and her associates aud together they approached 
reprcseututivc women of the Red Cross iu New York and 
Wusbiii^on with their su^estlous. While these steps were 
being taken the reorganization of the Red Cross by Act of Con- 
gress had \)een completed. 

The American Journal of Nursing said (March, 1905) : ^^ 

The plan of the reorganization of the National Red Cross 
Society is of special interest tv nurses in view of the fact 
that a committee was appointed at the last meeting of the 
Associated Alumna to arrange, if possible, for some form 
of affiliation with the Red Cross, so that the great nursing 
body of the country might have a recognized place in the 
Red Cross work. At the first annual meeting, held under 
the new charter, William H. Taft, Secretary of War, was 
elected president. The Executive Committee includes 
Surgeon (Junoral Wyraan and Miss Mabel T. Boardman. 

It is planned to have a conuiiittee of twelve in each State 
to work for the upbuilding of the Red Cross and make it 
more national in chnracter and it would seem a very natural 
conclusion to reach that nurses, who will be depended upon 
to do the hard, practical work in caring for the sick and 
wounded in time uf national calamity^ should . . . have 
representation on these committees, I 

In iliss Boardman the nurses were to come into close work- 
ing relations with a strong and judicious friend, a woman whoso 
abundant common sense and keen perception were of the great- 
est support and value in building up a Red Cross J^ursing 
Service. 

Mabel Thorp Boardman was bom in Cleveland, Ohio. Her 
family later moved to Washington and made it a permanent 
home. In 1900 when the American Red Cross was incorporated 
by^ Act of Congress, several persons who had worktnl in the Red 
Cross during the Spanish-American War asked Frederick 11. 
Gillett, wlio was in charge of the bill, to insert Miss Boardman'a 
name as one of the incorporators. She was active in the reor- 
ganization in 1905. In those early days there was but one paid 
employee, — the secretary^ and Miss Boardman freely devoted 
her time and resources to the work at Imme and abroad. She 
traveled over this country organizing Red Cross Chapters and 
went througli Europe and to Japan studying Red Cross organ- 
ization. In 1007 she was a delegate to the Eighth International 



I 

I 



REORGANIZATION AND AFFILIATION 75 

Conference in London and in 1912 to the Ninth held in Wash- 
ington. 

At a very early moment Misa Boardman realized that a nurs- 
ing service should be one of the moat important departments of 
the Red Cross. She made it a point to become acquainted with 
beads of training schools and assure them of her conviction that 
BOnefi themselves must take charge of the nursing department 
M they best understood nursing problems, duties and qualifica- 
tio&ft. With this object she made a visit to the Johns Hopkins 
Hoopital and met Misa Nutting and Dr. Hurd. In April, 1906, 
the spoke before the American Society of Superintendents of 
Training Schools on "The Red Cross Nurse" and in October, 
1907, wrote in the Red Cross Btdletin: 

There is no doubt that this important department of the 
Bed Cross work will greatly develop as the nurses themselves 
take the matter in hand and assist in this development. 

After ita reincorporation by Congress, the American Red 
rroes issued the following circular. It was reprinted in the 
Amrrican Journal of Nursing in July, 1905. In this circular 
tbr Red Cross Central Committee outlined its own plan of or- 
ganization and ideas as to the recruiting of nurses as follows: 

Aim axd Purpose of American National Bed Choss 

The International Conference which met at Geneva, 
Switzerland, August 22, 18G4, agreed upon n treaty for the 
purpose of mitigating the evils inseparable from war. Tliis 
treaty has been ratified by forty-four nations, including the 
United Stales. The conference recommended '''that there 
Bball exist in every country a committee whose mission shall 
consist in cooijcniting in times of war with the hospital 
•enice of the armies by all means in its power." It also 
recommended the adoption and use of a distinctive flag and 
■mi bad^'p. . . . 

The charter granted by Congress in January, 1905, to the 
American National Ked Cross de<'lared the purpose of the 
corjKiratiou to be: "To furnirih volunteer aid to the eick and 
wounded of armies in time of war, in accordance with the 
spirit and conditions of the Geneva Convention. . . ." 

"To rtmtinue and carry on a system of national and inter- 
national relief in time of peace, and apply the same in 
raitigflting the sufferings caused by pestilence, famine, fire, 
AochIj* and other great national calamities." 



76 mSTORY OF AMERICAN RED CROSS NURSING 



Congrefcs coneidered the importauce of the work so great 
that the charter granted in 11*05 provided for Governmental 
supervision. 

The charter conferred on the Board of Incorporators and 
the Central Committee the power necessary to carry into 
effect the above provisions. 

In pursuance of this authority the Central Committee pro- 
poses to organize in every Stale and Territory of the United 
States, branch societies, to eiuihle every person who desires 
to do so to become a member of the society and to awaken in 
this country the same interest in the objects of the organ- 
ization that is so markedly manifested in every other nation 
having a National Red Cross Society. 

The necessity of being prepared for emergencies has been 
too often demonstrated to require argument. The object of 
the Central (.*ommittee in to have in each State and Territory 
a branch society tliat will he ready to act at once in time of 
war or dittaster, and so strong in its persoauel that it will 
command universal confidence. 
I' i^l • Each branch will act as a unit in the organization and take 
charge iu case of any great calamity ii\ its State, Ita Execu- 
tive Committee or a Rpecial committee will enroll doctors and 
nurses for Red Cross service in time of war or great disaster 
in the State or its immediate vicinity. Reports as to the 
number of doctors and nurKes enrolled by each branch will 
be made annually through the Central Committee to the 
Army Aledicnl Department. , . . 

The secretarj' of each branch will keep informed as to the 
numbo*, names and addresses of the doctors and nurses en- 
rolled for active service. This service may be given either 
without compensation or for the same salaries as those paid 
by the War Department, — namely, one hundred and fifty 
dollars for medical ot^icers and for nurses, forty dollars a 
month for service in the Ignited States and fifty dollars a 
month for service outside of the United States. The secre- 
tary will also keep informed as to where hospital and relief 
supplies can be obtained at shortest notice.* 

••il; oJ 

At the time the circular was issued, plans for organization hj 
states wer^ already well under way. The District of Columbia 
had the first branch. New York perhaps made the best showing 
of the States, althougii California was also strong. Miss 
Delano \ms Secretary of Enrollment for New York State and 
Miss Palmer, of Rochester, editor of the American Journal of 

'In the Red Cross Archives. 



REORGANIZATION AND AFFILIATION 



77 



I 



i 



r. n-acLrd luirsca at large ; Miss Maxwell, eminent in the 
tifld, and Miss Wuld, head of the isurses (now Uenry 
Siretft) Si*ltlouii*nt, who h;d in social nioveineiits and altruistic 
work growingr out of the visiting nurac senice, all hent their 
best exiergii*8 to stiuiulute inti^n^st, uiemlKfrnhip and enrollments. 
Mrs. W. K. Draper received tlie appliratious for Now York 
nmulMTship uml Miss Delano sent out an urgi*ut appeal for 
PTcry nurso in the State to join and enroll. Two other nurses, 
Beatrice Von H(»mrigh SteviMison aiid Mnrv A. Gladwin, hoth 
of whom wc met first on the Lampasajt expedition, were espe- 
etally nnlirin;^ in their efforts to giiin new menilx^rs. 

By bceomiiig paying memlw^ra at a moderate fee, nurses as 
well as others would have had a vote in the management of 
Red Cross State w)eieties and it was then thonn:ht that in this 
wmy nurses could help to direct the details of nurse enrollment 
and their service in war or other calamity. The mere enrcill- 
mmt for such service was a different thing; it alone would not 
ttmfcT a voice in management; membership must also bo held. 
But nurse's did not come forward for membership or enroll- 
ment. Aa states organized and fell in line, state nurses* com- 
BUtteeB were, therefore, farmed to promote enrollments and 
•elect women of the necessary qualifications from among those 
wl» applied. It became evident that nurses would follow none 
but their own leaders and so it was hoped that wnuuittees of 
nurses in the various states could bring the rank and file into 
the enn^llmeut lists. 

The Anurican Journal of Nursing lost no opportunity of 
^viug publicity to Ked Cross events and information to its 
raadprs. 

In February, 1006, it explained editorially the reorganiza- 
tion of the lied Cross and the features of the new charter. It 
slated the restrictions on the use of the brassard and the 

ililem, whitih had been indiscriminately and improperly U8t»d, 

The arm piece or "lirasf'ftrd ,'* coneisting of a white band 
with a Red Cros«. may only be worn when on duty under the 
officers of the Ked Cross, No nurse has the right to wear it 
on any other occasion, nor has any other body the right to 
give it to her. There are souie Hurgicnl firms and Firet Aid 
corporations wbich have in former years legally secured the 
navof the red cross as a badge (for inntance Johnson & John- 
•on) and from these it cannot be taken away; but no one in 



78 HISTORY OF AMERICAN RED CROSS NURSING 

future rnii ever obtain this privilege. The lawB of all coun- 
tries rigidly protect the use of the Red Cross as an emblem 
reserved to the national societies and their workers on the 
buttle field, or in the camp or hospital in time of disaster. 

Miss Boardman, too, was untiring in her efforts to make plain 
the purposes and plans of the lied Cross. lu her travels over 
the country she spoke before many gatherings of nurses. She 
dwelt npon the importance of the nurse^s place in the recon- 
structed Red Cross, emphasized the high standards that would 
be required and told her hearers that it was agreed by the 
Government that, in case of war, the Red Cross nurses wonld 
be the Army Reser^•e. 

At these meetings she explained the two forms of agreement 
then existing, one for paid, the other for volunteer service. The 
latter did not signify amateur service, but presumed that fully 
trained women might sometimes bo in a position to give their 
aid without compensation. 

VOLUKTEEE NURSE 

I hereby agree to hold myself in readiness and to enter the 
service of the Ameriian National Red Cross when and where 
my services may be required at! a nurse, without compensa- 
tion except transportation and subsistence. 

Paid Xitese 

I hereby agree to hold myself in readiness and to enter 
tlie service of the American National Red Cross when and 
where my services may be required as a nurse, with eom- 
I>enfiation at the rate of forty dollars per month when on 
duty in the I'nited States, and fifty dollars per month when 
witfjout the limits of the United States, in addition to trans- 
portation and subsistence. 

She also set forth the rules that had been agreed upon for 
the enivdlment of paid and unpaid nurses. As there was, then, 
no nursing eonunittet^ at the Washington headquarters, these 
rules had been framed by her in consultation with the New 
York State and District of Columbia members. 

1. All nurses enrolled for service under the American 
National Red Cross shall be required to show a certificate of 
registration when eoroUed in states or territories where 



REORGANIZATION AND AFFILIATION 79 

registration is required by law. Ntirees enrolled In states or 
territories where rcgistrntion is not required by law sluill 
show a certificate or diploma of praduntion from a reco/;:nized 
training school for nurses requiring a course of not less than 
two years. 

2. No nurse under twenty-five years of age fihall be en- 
rolled for active gervice. 

3. All applicants shall be required to give a physician's 
certificate of gound health and unimpaired faculties, which 
certificate shall be renewed every two years. 

4. The moral character, professional standing and suita- 
bility of applicants for enrollment as nurses shall be de- 
termined in such manner as the branch society may prescribe.* 

At that time New York State bad one of the first and best 
inr«o registration acts and the Red Cross State Committee had 
lid down thcee additional stipulations: 

1. All nurses enrolled in the State of New York for Red 
Cross service shall be required to show a certificate of regis- 
tration with the Regents of the University of the State of 
New York. 

2. All applications must have three signatures, vouching 
for their moral character, professional standing and suita- 
bility to this special work — two from nurses of good stand- 
ing and the third from the president of the Eubdivision. 

9* ■ • • 

4. All applicants must appear before a member of the 
Nurses' Committee for examination, and must present to 
the committee with their other papers, the endorsement of 
their applications by that member of the committee. 

6. . . . 

District of Columbia Branch was the first to arrange 
lecttircs designed to attract nurses to the Red Cross 
and also to enlarge their information. The Red Cross 
tuUsiinr, April, 1907, has the following record of this effort; 

The District of Columbia Branch is preparing to give to 
its enrolled nurses a special course of lectures with practical 
demonstration of field hospital work uuder the auspices of 
the Me<]ical Department of the Army. These lectures will 
be given at the Washington Barracks. 



Article 
VoL 



bf Vi«B Boardman, Amerioan Jourru/i of Kurginif, August, 
VI, p. 810. 



80 HISTORY OF AMERICAN RED CROSS NURSING 

A syllabus of tbc lectures follows: 

L General outline of the or^^nizntion of the Army iu time 
of war aiul of its nie<lical and sanitary service. IF. The regi- 
mental hospital. Tlie ambulance section. The tield hospi- 
tal. The base hospital. Other hospitals and stations. III. 
Medical and sanitary service of camps and on the march. 
IV. Service in battle at the front. V. Service in battle at 
the rear. 

One afternoon will be devoted to the practical demonstra- 
tion of the field hospital. This will he done at the conclusion 
of the eoursi: as deUiiled above. An opportunity will then 
be given to examine the equipment and working plan of the 
organization. 

One of the siibjects brought forward and exciting warm dis- 
cussion in the early formative period^ before the final utliliation 
of the Red Cross with the nurses' association had taken place, 
was that of the desirability of giving elementary instruction in 
nursing to women of the home under the lied Cross auspices. 
The District of Columbia Chapter had pioneered in holding 
classes of this kind and Beatrice Stevenson, attracted by their 
e.xample, initiated similar work in Brooklyn (1908) in a set of 
talks on Hygiene, Sanitation and the Emergency Care of tiio 
Injured. 

This new departure elirit/^d, at first, considerable opposition 
among nurses, who feared that the Anierican l^^d Cross might 
perhaps follow the example of European societies iu promoting 
a superficially trained voluuteer nurse corps, which would in 
the event of war or other disaster, cause confusion and difficulty, 
A meeting of the Now York County Nursps' Association was 
held in the Bcllcvue Nurses' Club, in April, 190S, where the 
allied questions of nurses' enrollment in the Red Cross and the 
evolution of teaching under its banner were warmly discussed. 
It now swms obvious that the very concern felt over such pos- 
sible development, brought homo to nurses a sense of their own 
duty to the lied Cross. The two questions were introduced 
together by Miss Pindell, who stated that the Alumuas of the 
New York City Training School for Nurses had sent a com- 
munication to the Nurses' Committee of the New York State 
Red Cross branch, asking for recopi»ition as an association 
desirous of affiliation with the Red (^ross Nurse Corps. Miss 
Pindell read tlie answer rec«ived, also the ndes of the com- 
mitteo in regard to tbe enrollment of nurses. The syllabus of 



REORGANIZATION AND AFFILIATION 



s: 



g:iven 



I 



tlie oooTse of lectures on Home Care which had 
Wufaingtoii iiuder the auspices of the lied Crosa, was aiao reaa 
tad Miss Damrr was asked to open the discussion. A BcUevue 
woman (18S5) and a Canadian, she hud long held responsible 
positions in nursing associations. She had been one of the chief 
builders of the Associated Alumnae and State nurses' societies. 
She now said, with the strong common sense which was her 
feftdiug characteristic, that she felt that the nursing profession 
kttd not been doing its duty by the Red Cross, for as the latter 
Imi shown its readiness to conform to the nurses' standards, 
the nurses should either have enrolled in force or stated why 
they were not willing to do so. If they took no action in the 
flutter they must expect that the lied Cross would take other 
■teps to provide nurses for its work. 

Miss Gladwin and Mrs. Stevenson, who knew that the pur- 
pOMB iixid plans of the Ked Cross were not directed toward the 
creation of a short term nursing corps, spoke in defense of the 
Home Nursing teaching and wliat they said has been amply 
jostiBed by time and by the ultimate (*oiiperatiou of nurses as 
« body in guiding the direction of classes for women of the 
Ikome. 

Mrs. Stevenson spoke of the new policy in the Red Cross, of 
guarding health, and mentioned the international resolution of 
London (1907) to the effect that Red Cross societies might take 
a share in the warfare against tuberculosis. ° She quoted Major 
Lynches address at the annual meeting (1007) of the New 
York State Ued Cross Branch, in which he had said that, in 
order to get members and to keep up their interest in the Red 
Crow, oppf)rtunitie8 should be seized to show individuals that 
tEey had a part to play in Red Cross work and that universal 
inatruction of people in the laws governing sanitation would 
wezn to be a peculiarly appropriate field of work for nurses. 

ifise Gladwin spoke to the same efFect." An article written 
lat^r by Mrs. Stevenson said in 



part 



It haa been said that social efficiency depends upon a 

of social res[>onsihility. ... It was this spirit of soeial 

rwpoosibility which prompted the Red Cross to undertake 

a campaign of health education with reference to the pre- 

*T%c JkmtrlcMU Red Crose opened its flret Day Campe for Tuberculosis 
li Jane, l^OS- Many others followed and brought nurses into contact 
mUit Ike Ktd Cross. 

*Sbe Atrntneon Journal of Nuravng, May, 1008. p. 603. 



82 HISTORY OF AMERICAN RED CROSS NURSING 



vention of disease and amdentR, and the highest degree of 
social efficiency of both societieg, the Nurses' Associated 
Alumnffi and the Red Cross, can best be reached by the affilia-! 
tioD of the nurses with the Ked Cross and the hearty co- 
operation of both in the furtherance of this public health, 
work. 

The registered nurses have heen asked to cooperate witlx< 
the Red Cross in this work by delivering these addresses. 
Two reasonable objections have been offered^ one, that thfr' 
majority of nurses know nothing? about teaching and are not 
accustomed to speaking in public; the other, that as time 
means money to the majority of uurses. it will be impossible 
to do any effective work unless the Red Cross can have salaried 
teachers. It is probable that for some of this work the Red 
Cross will arrange a definite course of instruction M'ith salaried 
teachers, but in a movement which it is hoped will become 
as wide-spread and far reacJiiug as this, some of the pioneer 
work must be voluntary.^ 

After the first doubts of the nurses were allayed, it is certain 
that to most of them the prospect of peace activities under the 
Red Cross was more attractive than war work. Those especially 
who were absorbed in teaching and training for lives of con- 
structive usefulness btK'ume greatly interested in the class-work 
plans. For some years this interest ran parallel with "affilia- 
tion" and will be show^n brieily in that way diiriu^ the early 
stages of growUi, while the details will be presented fully in the 
section on class work and teaching. 

The calls made upon the reorganized Red Cross in its early 
years, by the calamities of the Japanese famine and the Saa 
Francisco earthquake and fire, gave the nation striking lessons 
which it W(i8 not slow to learn, but the nursing reserve was then 
not well enough organized to make a record and individual 
nurses came forward as volunteers in San Francisco in response 
to telegrams from headquarters. The American Journal of 
Nursing pressed home the lesson by saying: 

We urge upon all nurses enrollment in the Red Cross 
Society, as working members if possible, as contributing 
members without fail. This is one of the obligations of 
citizennhip or residencre in this prosperous country. 
Will the nurses of this country learn a lesson from thia' 
greatest national calamity? 

*8«« American Joumnl of yuraing, Juno, 1008, p. 701. 



REORGANIZATION AND AFFILIATION 



83 



Imprciseed by these events, the Red Cross nnd its nurse mem- 
bcni redoubled their efforts to build up enrollment and member- 
ship, but weak spots presently appeared in the professional 
[uiremeuU of state units. The standard of the Regents' 
Linatiou set by New York was not aeceptnblc to others. 
'ennsylrania, for instance, desired to make exceptions, as in 
following clause : 

Nurses who have graduated in less than a two years* 
course must have served at least tlireo years at nursing after 
graduation and be recommended by two doctors as to efficiency 
as nurses. 



To this ambiguous proposal Afiss Boardman n^plied with 
•at clearness and decision. All questions of this kind then 
to her for final answers and it is fortunate for the Ked 
Nursing Service that her administration was so able and 
Sbe wrote (July, 1008) : 

The rule that all of the American Red Cross nurses must 
be graduates of recognized training schools with at least two 
years' training in the course is of Hrst importance and a rulo 
that cannot he omitted. The Army makes this one of its 
regulations and we cannot be le^ particular, not only on this 
ftccount but for mantj other reasons. At the time of the lato 

war. tiie state branch of the Hcd CrosH sent out a 

Domber of nurses to the Philippines whose characters were 
of nch a nature as to force the United State-s to require their 
ncalL • . . Later when Mrs. Wliitelaw Reid had charge of 
■Bcii matten for the Xew York Red Ctoss the nurses were 
■riacied for their character and ability and as a result most 
cxc«ll€ut women went. We can run no risk of repeating 
the . . . experi^ice by taking in as Red Cross nurses women 
whoee character, training and ability have been guaranteed 
bj DO one. I would rather have no nurses at all than run 
ftoy each risk. . . . Quality mui^t come first, quantity sec- 
ooiL . . . Certain regulations must be observed; if they are 
aot willing to observe them in Philadelphia we will get our 
omRi irmn elsewhere. According to these rules any nurse 
vbo had recesved one of those six weeks' training coursea and 
opold get two pkjiicians to testify to her efficiency, after she 
iBid been pncOciu for three years could become a Bed Crosa 
nunm^ Am a remH we would promptly loae our best nunea 
ovnelTes with a second rate and poor lot of 
Sot only is the two years of studj and training 



"1:-. 



84 HISTORY OF AMERICAN RED CROSS NURSING 

oecewary to make a good norse, but tbe discipline that these 
scbooiA provide i& of great vaiue. We pay far too little at- 
tention to this. 

To the officora of the Pennsylvania Branch, all of whom were 
men, who wrote asking: 

WIio appoints the Committee on Nurses, and could the 
committee comdat of the president and secretary of any 
State branch? 

Mlaa Boardman replied: 

A Committee on Enrollment might be appointed by the 
chaimiau ot the Executive Committee or the pre-sident of a 
Branch. . . . There Is no reason why the president and 
Re<.Tptary of a Branch should not Ix? member* of tiie t-om- 
mittee for the enrolhnent of nurses. It would seem advisable, 
however, to have as a third member of such committee the 
superintendent of Bomc training school of unquestionable 
standing. 

The above material selected from among other examples illua- 
tratca tho firm, intelligent 8uppf>rt given by Miss Boardman to 
the ideals of good nursing and shows her part in maiutaiuiug 
fitundards in the Rod Cross Nursing Service. Such examples 
recur from time to time, but this one will suffice to make the 
point 

An excellent plan now devised for the Nursing Service of the 
Bed Cross State Branthes was one whereby the 8up*?rintendentd 
of training schools might be secured, if necessary, to take com- 
mand in time of need, such as war. The American Journal of 
Nursing, December, 1000, said of this; 

A meeting of the New York Committee for the enrollment 
of DurwH for Bed Cross service was held at the house of 
Mrs. William K. Draper, on October ID, lUOS. It was de- 
cided to enroll two clansee of nurtrCH for Red Cross service; 
the regular private nurses for field wtirk and hospital nurses 
for adminii^trative work, the conditions of salary, health 
certificates, etc., being identical for the two. This will make 
it possible for many of the older women holding jwMtions 
at the head of hospitals or training whools, to enroll for Bed 
Crosi* fluty ainl will insure to the Bed (Voss the nervices of 
trained executive heads if, in emergencies, temporary hos- 
pitals have to hi' nitablishrd. By this provision also, there 
would be no age limit, as many of our most valuable workers, 



REORGANIZATION AND AFFILIATION 



85 



who would not feoi physically able to give field service in 
emergeijcie-s, will enroll with the prospect of being able to 
derre the country as supervising uurses. 

Tbe New York Red Cross oominittce decided in 1907 to 
etm>]I dietitians for hospital service and Miss Corbett, dietitian 
of tbt> Department of Churitios in New York City, was placed 
the nurses' committee to draw up proper rules for suck 
llmenta. 

In iy07 the Executive Committee of the American National 
Red (^rciss issued resolutions explaining the protectiou of the 
Lmblezu by international treaty and requesting that all hospi- 
Uk and eommercial firms give up its hitherto widely exploited 
OK. The latter resolution follows: 

Be it Resolved : That the Executive Committee of the 
American National Red Cross request that alt hospitals, 
he«Jth departments and like institutions kindly desist from 
the use of the Red Cross created for the special purpose 
mentioned above, and suggests that for it should be sub- 
itittited some other insignia, such as a green St. Andrew's 
cro0e on a white ground, to he named "Hospital Cross'' and 
used to designate all hospitals (save such as are under the 
Medical Department of the Army and Navy and the author- 
ized volunteer aid society of the Goveniment), all health 
departments and like institutions, and further, 

Be it Resolved : That the PLxeeutive Committee of the 
American National Red Cross likewise request that all in- 
dividuals or business lirms and corporations who employ the 
Geneva Red Cross for business purposes, kindly desist from 
«ich use, gradually withdrawing its employment and substi- 
iDting some other distinguishing mark.' 

TbiA rwjueat was generally heeded ; thus Robert W. Heblxjrd, 
thm Commissioner of Public Charities in New York City, 
lolvtitiited for the Ptcd Cross on the sleeve of the white uni- 
fofiDA in the city hospitals, the staff and serpent of Aesculapius. 

In that year (1907) occurred the first instance of a County 
iJlnrses' Society joining a Red Cross State Branch as a body, in 
tbe ftifiiiation of the San Francisco County Nurses Association 
nitL the California State Red Cross. Another and different 
ttrly grouping waa shown in the nHiliation of the District Nure^^ 
i&f; AfiBociatiou of Troy, New York, with the Red Cross. 

In tlie uutumn of 1907, the American Journal of Nursing 

'Minutes of Ootral Executive CoTximlttec, Vol. T, p. 102. 



86 HISTORY OF AMERICAN RED CROSS NURSING 



established a Red Cross Nursing Department, for the purpose 
of spreading knowledge more widely among nurses and stimu- 
lating their interest by giving reports from all sections of the 
eountry. It was at first edited by Miss DcWitt, editorial 
assistant in the Journal office. With tliis department a system- 
atic and complete history of Red Cross nursing growth and 
activity appeared regularly mouth by mouth. lu that year 
also, the International Kid Cross had resolved to take a part in 
the crusade against tuberculosis and it was realized that this 
would need the services of many more nurses. But with all 
these efforts^ it became clear that nurses were not closely enough 
approached and that they were hanging back. Between the 
Rod Cross Central Committee at Washington, the State so- 
cieties with the nursing committees and \\\i' individual nurse, 
there was too leugtii}' a line of communication. Perhaps lead- 
ing nurses felt this even more definitely than did the Central 
Committee of the Red Cross. They were aware that the nurs- 
ing service was too loosely knit together to hold well in a dire 
emergency. They then made the suggestion that instead of 
State nursing committees within Red Cross State societies, 
the State Associations of Nurses, by that time strongly devel- 
oped throughout the comitry, should themselves be the bodies 
responsible for enrollment and should cooperate in this work 
with State Red Cross societies. Several states had actually 
brought such an arrangement into being. Miss Dauier, presi- 
dent of the Associated Alumna?, pointed this out in her address 
at the Tenth Annual Convention in 1007. She said; 

Another matter in which we have made the discovery of 
the need of cooperation is the Red Cross work. . . . The 
Red Cross calls upon us nurses in itM work in many ways. . . . 
It has been suggested that we ask the fttate (nursing) associa- 
tions to cooperate in this matter, to form auxiliary societies 
among their members or have committees appointed who will 
enroll nurses for the Red CrosH work. Ohio is very well 
organized in that respect, and California has recently started 
au auxiliary. 

In 1908 came the first severe test of the efficiency of the 
Red Cross Nursing Reserve, with the calls for help from inun- 
dated sections of ^lississippi, following the toniado and floods 
that occurred in April of that year. By dint of great eflfort, 
the need was met, but the macbiners' creaked, as explained with 
candor by the American Journal of Nursing ( Juue, 1908). 



REORGANIZATION AND AFFILIATION 87 

After reciting the incideuts of mustering the required nurs- 
ing roervea, it said editorially: 

Judging from these facts, one receives the impression of 
pffompt and efficient servirc, but knowing the inner side of 
the •tory. the nursing profession is given some cause for 
wriouA reflection. . . , 

Tbe question before us is how to bring all of our forces so 
into cooperation with tlie Red Cross that prompt and efficient 
•vice may always be at the command of that society with- 
it unnecessary delays. 

All other considerations in connection with the Red Cross 
are secondary to this one of etiicieut enrollment. It should 
be taken up by every local organization and carried into our 
slate and national conventions until the problem has been 
«atis.factorily threshed out. Otherwise the Red Cross will 
be forced to train its own workers. 

So far all the steps taken toward providing a Hed Cross 
Xursiug Reserve had proved to bo but tentative and oppor- 
tnniatic and did nut satisfy the nurses themselves. 

The i^nuiue afhliatiou of organized nursing bodies with the 
Bed Cross which finally took shape, began with the work of 
babel ILirapton Robb in 1008-1909, though her plan did not 
then earrj' in its original form. The story is fully told in Mrs. 
Bobb*s words at the second convention of the Federation of 
J^QTvea. This body, it is to be remembered, was composed of 
tbp two eocieties, the Superintendents and tho Associated 
Ahumuc in joint meetings. 

At the Superintendent's Convention in April, 1908, Miss 
Xuttiugr its president, had asked Mrs. Robb to serve as chair- 
a Red Cross Committee and to enable such a committee 
fcr with the Central Committee of the Red Cross for the 
of tinding out whether any arrangements could bo 
whereby a settled Red Cross Nursing Service might be 
ibltftlied. The following women were selected to serve with 
Mr*. Robb: Miss Damer (representing the Alumnte), Miss 
Xotting (the Federation), Miss Nevins (the Superintendents* 
uetv) and Miss Maxwell, who had had great experience in 
Red Cross work of the Spanish-American War, as member 
Urge. 

On JuDC 13, 1908, Mrs. Robb wrote to Miss Boardman tell- 
iag her of tbe nnrses* wishers and of the existence of the com- 
iliae Boardman replied on July 20, 1908, saying: 



88 HISTORY OF AMERICAN RED CROSS NURSING 

I was very glad to receive your letter and am delighted. . . . 
Thin ftpriug there were created three Red Cross Departments 
on. first, War; second, Emcrgonry, and third. International 
Relief. A Board is at the liead of each Department (jleneral 
O'Reilly, Surgeon General of the Army and a memher of 
our Central Connnittet^, is tlie chuirman of the first Board 
and I am chairman of the second. At the time of our annual 
meeting in December, tlie 8th and 9th, there will be meetings 
of these two Boards and there will also be a meeting of the 
Emergency Board in Waphington the first part of October 
and probably also a meeting of the War Board about the 
£ame time. 

If you are near Washington at that time and could meet 
these Boards it would be very useful as they are the Boards 
which will have active charge of those relief measures in 
which we would probably need tlie nurses' assistance, 

Mrs. Robb and Miss Maywell went to Washington in October 
and had an informal conference with Miss Boardman and Mr. 
Bickncll. They retairncd to New York and met the other com- 
mittee members, no definite conclusion being arrived at. Mrs. 
Robb next summed up the substance of their conference with 
the Rod Cross officials in the following letter to Miss Board- 
man: 

Cleveland, October 15, 1908. 
My dear Miss Boardmen: 

I beg to submit to you in writing the substance of the 
conversation Miss Maxwell and myself had with you on 
October 4, to the effect that the Federation of Nurses, which 
. . . numbers about 15,000 members, appointed a s|HM:ial 
committee to confer with the Central Committee of the Red 
Cross to find out if it might be possible to make suitable 
arrangements whereby all nursing and allied work required 
by the Red Cross Society migiit he done through the Federa- 
tion of Nurses under proi)er organization. Unless some such 
organi/jition is effected the mojority of nurses feel that ihe 
m<»st eflicient nursing work cannot he attained, nor the proper 
selection of nurses made, and that in consequence all mem- 
bers of the profession are subject to unnecessary adverse 
criticism. The nurses also feel that suitable recognition 
should be accorded them as a body of professional women and 
the integrity of their work should be maint^iined. To those 
of us who have given the matter careful thought, it would 
seem that a satisfactory* agreement to both the Red Cross 
and the Federation of Nurses might be reached through 



REORGAXIZATION AND AFFILIATION 89 

ftffiliation, whereby a nursing department carefully planned 
in every detail might be organized that would cover all 
branches of Hed Cross nursing, including that of the Army 
and Xavy. This would not necesparily mean that women for 
appointment to any branch of the Red Cross nursing work 
must be a member of some nursing organization, but that she 
should have the qualifioations now considered essential for a 
nurse in good and regulor t^tantiing. If the Central C'ora- 
mittce of the Red Cross is willing to consider this atflliatioa 
proposition, then it will be necessary to hold a conference 
to decide upon what grounds such an atliliatiou can be best 
worked out. 

Very truly yours, 

(signed) Isabel Hampton Hobb. 

'!o this Miss Boardman replied: 

My dear Mrs. Robb: 

Your letter of the 15th has been forwarded. ... I feel 
confident that a plan satisfactory to all can be worked out. 
1 shall be at my office in Washington on Thursday and then 
will go into the matter at length. I want you on the War 
Relief Board and as a meeting of the Board will be held soon 
after my return to Wasliington, your appointment will tiien 
b** arranged for. The Red Cross president, Mr. Taft, makes 
this appointment 

Yours sincerely, 

(signed) Mabel T. Boabdman. 

week later Miss Boardman wrote again to Mrs. Kobb: 

There has not yet been a meeting ol the War Relief Board, 
but 1 think one will be held next week at which time your 
letter will be presented to the Board and at the same time 
your appointment as a member of that Board to represent 
the Trained Xurse part of the Red Cross and as a represen- 
tative of the Federation of Nurses, will be made, I feel 
sore tiiat this proposed afTdiatiou with the Federation of 
Nnrses can be brought about in a way satisfactory to all. 

Please let me know when you expect to be cast so that a 
meeting of this Board can be held during that time. A 
meeting of this Board will also be held about the time of the 
r^aUr annual Re<l Cross meeting, December 8. At the 
meeting next week or thereabouts, I will read your letter to 
me of October 15. 

In order that Mrs. Bobb might obtain a seat on the War 
Rdirf Board, Miss Boardman generously resigned her own, 



»0 HISTORY OF AMERICAN RED CROSS NURSING 

thus creating a vacancy wliich Mra. Robb was appointed to fill, 
January, 1909. 

Having conferred with her committee, Mrs. Kobb attended 
the War Relief Hoard meeting in Washington (March 25) and 
there submitted the plan of affiliation as agreed on by her com 
mittee. The plan was, with but a few modifications, the same 
as one drawn np by Mrs. Robb herself, earlier in the winter, 
which had been informally discussed at Red Cross Headquarters 
and which is now in the Red Cross archives. This historical 
detail explains dual allusions in Red Cross official material to 
'^Mrs. Robb's Plan" and "Mrs. RobVs Committec^s Plan." 
Both were essentially the fruit of Mrs. Robb's ideas. The plan 
presented follows: 

To the Red Cross Board of Control of War Relief:— 

The committee appointed by the Fetlcration of Nurses to 
devise a pku whereby the Red Crosa might enter into allil'ia- 
tion with the Federation of Nurses for nursing purposes, begs 
to suggefit the following plan for your consideration. 

Whereas it has been proven that volunteer service by the 
individual nurse is not a inuccess owing to the fact that it is 
impossible to count upon her services in emergency: — 

It would seem advisable to form a regular nursing depart- 
ment of the Red Cross. That a permanent Chief Nurse hav- 
ing the requisite training, e^cperienec and organi;;ation ability 
be appointed to the head of this department. That the de- 
partment be subdivided into four large sections, that (»f tlie 
North, South, East and West, and that a permanent Head 
Nurse be placed over each of these. That the Federation of 
Nurses be asketl to affiliate with the Red Cross for the pur- 
pose of supplying the main nursing force. This force to be 
composed of its members specially selected, and in considera- 
tion of this, the Federation would request the following 
privileges: 

That its nursing force be drawn upon first for active 
service; that this nursing force have the privilege of wear- 
ing the Red Cross brassard on nursing service of any kind; 
that an executive committee from among its members Blmll 
be appointed by the Federation Council to act with the War 
Relief Board of Control; that the Federation be represented 
at the Reil Cross annual meeting by one or more delegates 
seletrted from the Federation. 

The source of supply shall l>e drawn from the ranks of the 
Federation, fr<»m other qualified nurses not memhers of the 
Federation, from Sisterhoods and from so-called "experi- 



REORGANIZATION AND AFFILIATION 



91 



enced nurses." It is further suggested that in order to insure 
a ready supply of nurses the l^ederation of Nurses be asked 
to fomi a central directory in all thn large cities of the 
Union and the head nurse in charge of these directories be 
put on the permanent staff of the Red Cross Nursing Depart- 
ment subject in emergencies to orders "from the uatioaaf head 
.Durfte. ^ 

^utie^ of the Chief Nurse: 

To organize the nursing force in detail in cooperation with 
the Executive Committee and Board of Control and the sec- 
tional head nurses. To keep corrected lists of all nurses on 
the sectional registers. To visit and inspect the various 
sections from time to time. To arrange for special courses 
in emergency training throughout the country. To arrange 
for Home Nursing courses in the various sections. To talk 
,npon Red Cross nursing matters wherever and whenever 
le^sirahle. To study Red Cross nursing organizations of 
other countries with a view of improving that in America. 
The Nursing Department of the Hnlhiin to be edited by her. 
DutifM of the Seciwiml Head Nitrse: 

To make lists with records of all trained nurses in tlieir 
eectioDs : 

1. Number of Federated Nurses. 

2. Number of Graduated Nurses not in the Federation. 

3. Number of Sisterhoods — available. 

4. Number of experienced nurses — available. 
6. Lists of nurses on direitories. 

6. Lists of all available nurses. 

7. Represent Red Cross work by at least one lecture be- 
rre students in training schools. To arrange for and over- 
courses on emergency and first aid nursing. Also to give 

mrses on home nursing. To cooperate with other Red 
Croes work where possible. 

(signed) Isabel Hamitox Robb, Chairman. 
Annie Dameb, 
M. Adelaide Nuttino, 
Georgia Nkvins, 
Anna Maxwell. 

There werp present besides Miss B<^ardman, Surgeon General 
Toroe^, Dr. Wise of the Navy, and Major Davis, Exception 
W9B taken (quite properly) to the point concerning the use of 
the braflBard (a mutter which could have been easily arranged) 
fnd to the expense the scheme would entail. The members 
pnsent seemed, reasonably enough in so early a stage of the 
Otganization, unready to accept so considerable a plan, as tlierp 



92 HISTORY OF AMERICAN RED CROSS NURSING 



many nurses. 



would not always be a need for a gi 
Kobb suggested, in answer to this, that they nii^ht Ik> used in 
nursing people of moderate means, but that, it was thought, was 
outside the Red Cross province. 

The meeting then adjourned. The plan was talked over 
further bv tlie Red Cross officers, who thoupht it elaborate and 
complicated, and a little later they sent the following statement 
in regard to it: 

At a meeting of the War Relief Board held March 25 at 

the National Hearlqiiarters in the War Department the sug- 
gested outline of plan for the affiliation of the Federation of 
Nurses with the Ked Cross, prepared by Mrs. Robb at the 
request of the Board and after consultation with the Federa- 
tion of Nurses' committee on Red Cross nur^iin^, of whieh 
Mrs. Robb is chairman, was presented by Mrs. Robb and 
informally disruepGd. The Board considered the plan care- 
fully studied out and containing valuable suggestions, but 
that as the carrying out of such a plan would involve a large 
expenditure of money from the Administration Fund of the 
Society, the Board felt that it would be impossible under 
present conditions for it to undertake any such elaborate 
plans. Mrs. Robb thought that it would involve an annual 
expenditure of from nine to ten thousand dollars to carry 
out tlie proposed plan. 

As experience has ehown that for both war and emergency 
relief, tlie services of a number of nurses have very seldom 
been required for strictly Red Cross work, the Board ques- 
tioned as to whether i\i any time it wouM lie ju8tifie<i in such 
a large annual expenditure for the jjroposed plan unless some 
continuous benoQeial use within the Red Cross sphere of 
work could be made of this affiliation. 

The Board hoped that for the present a plan for some 
limited affiliation may be brought about that will involve 
little or no expense to the Red Cross. It is desirous of ob- 
taining the interest, support and assistance of the Federation 
of Nurfles in Kcd Cross work so that the trained nurses of our 
country mny be able to take their part in tlie patriotic and 
humane service of the Society in time of war or disaster. 

The Board desired to express its thanks to Mrs. Robb and 
the other members of the Federation of Nurses' ctjmmittee 
on Red Cross nursing for the eare and thought given the 
prnpojied plan and regret that the financial question makes its 
adoption under existing circumstances impossible. 

Chairman, Red Cross War Relief Board.* 
* Minutes, Meeting War Relief noard, March 25, IDOD. 



REORGANIZATION AND AFFILIATION 



93 




TbiiB Uic first negDtiations failed, but, in the light of later 
illarj, it is intrrrsting to pause a moment and consider how 
ife'lBad Cross Nursing Service has actually developed, along 
lhsjfaaii:<»f the plan presented by Mrs. Robb. The Department 

'V , r '. ■ , :i3 evolved for war purposes almost exactly as she 
I and gave striking testimony to Mrs, Robb*8 vision 
and foresight. 

The decentralization of the service, as suggested by her 
under four sections, was rapidly effected after the declaration 
of wnr (1017) but instead of four it was necessary to create 
mrleeu divisions, in each of which a full time, paid nursing 
»r Vfiih a staff has been required.'" The Executive 
ittee of her plan exists as the present National Committee 
on Red Cross Nursing Service, 

The provision to include Sisterhoods was carefully con- 
tidered (1S14) and found of much practical value. For ex- 
ample, the nursing personnel of Base Hospital No. 102, from 
Xew Orle-ans, was directed by Sister Chrysostom Moynahan 
ind inelnJed ten other Sisters. Practical nurses were utilized, 
t^iw-cinlly during the influenza epidemic in 1919-1020, when 
many hua<lrt»ds of women were needed. 

The su^^gested directories us centers for euroUment were not 
T' ■. any extent but, instead, local conunittees of nurses 

I :<» st-ate associations were organized and tliey collected 

rredi^ntials, (>asaed upon the profcKsional qualitications of appli- 
cants and linuUy forwardt*d all papers to National Headquarters 
where they were tiled. The duties of the chief nurtvt* as indi- 
olcd hy Mrs. Robb are almost identical with those of the 
Dirertor of the Department of Nursing. Time has shown that 
hrr grneral plan, while a little startling when tirst submitted to 
ihe War Relir-f Board, and probably as a beginning too elalxv 
ntc, ws« gradually accepted and that a still further elaboration, 
on tai even more gi^uerous basis, soon boearae necessary. It was 
tunate that this was so, for upon the declaration of war in 
il, 191 7f there were 7000 nurses enrolled under the Red 
I well organized were its state and local committees 
[Jment was easily increased with great rapidity. 
Mrj. Robb did not emlK>dy in her plan her conviction that the 
Red Cross nurses should form the Army reserve but her mind 
vu dear on this point. Finally her hope of seeing Home 
N'oreing classes developed on a national scale has been fulfilled, 
TbU number under pcacv conditions wa« reduced to «ight. 




94 mSTORY OF AMERICAN RED CROSS NURSING 



beyond, perhaps, even what she foresaw as possible, as we shall 
learn in another chapter. 

The Central Committee of the Red Cross, disappointed in 
their first attempt, took counsel among themselves and planned 
another way of solving the nursing qufstion. 

In May, 1009, the War Relief Board proposed placing the 
Red Cross Nursing Department under a special subcomraittea 
and sent to Mrs. Robb the following resolution passed by them 
on May 7 to that eflFect : 

Resolved, That the subcommittee on Red Cross Nursing 
Service P^iall consist of a chairman aud fourteen other mem- 
bers, five to constitute a quorum. The chairman and fi\"e 
members to be members of the War Relief Board, to be ap- 
pointed by the chairman of the Board; fix members to be 
appointetl by the chairman of the Board from a list of 
trained nuri^es submitted by the Nurses' Federation, and three 
persons to be appointed by the chairman on recommendatioa 
of the Board. 

The chairman and two other members of the committee 
to be selected from trained nurses, members of the War Relief 
Board. Of the three other members one should be a surgeoa 
of the Army, one a surgeoti of the Navy, and the third some 
other member of the War Relief Board. This will give a 
membership of nine trained nurses on a committee of fifteen.'*^ 

The resolution was read by Mrs. Itobb as a part of her 
report at the annual convention in Minnoa[M)lis (1909) and 
discussed. . Mrs. Robb was keenly disappointed in that the 
work and thought she and her committee had put upon their 
plan seemed to have In^en lost, and she feared that the hope of 
satisfactory affiliation bad faded. But her intense idealism and 
love of perfection perhaps led her to forget how now and un- 
tried, as yet, was the American Red ('ross organization. It is 
easy to see, now, how formidable and binding the plan must 
have seemed to the Red Cross executives. Other nurses realized 
this at the time and believed that it would be better to begin in 
a smaller way and to build up little by little. The suggested 
committee of fifteen seemed to them a sensible compromise 
and Miss Palmer arose as the spokesman of this group. She 
spoke of being an officer in the Rochester branch, reviewed the 
general conditions of Red Cross state work and offered this 
motion : 

^'^UriutM, Wflr Relief Board. May 7» 1900. 



k 



REORGANIZATION AND AFFILIATION 95 

BesoWed, That the American Federation of Kurees 
aililiate iii a body with the Niitiujiai Ked Vtors Society and 
that nurnei? be nominated by this association to serve with 
the National Red Cross Committee as outlined by the 
National War Relief Board. 

Mies Delano had gone to the Minneapolis meeting with a 
hope iii securing the assent of the Federation to the proposal 
nude by the Red Cross. Miss Palmer wrote later : 

I know from my close asBoeiation witli Miss Delano in 
those early days . . . that bhe had very definite plans for the 
development of the service. , . . Although I submitted the 
reK)Iution for ofliliatiou it was really Mits Delano's resolu- 
tion, as she had it written out in ink before the meeting 
and, sitting next to me, asked me to present it." 

There was au animated discussion and the resolution was 
adrrpted, but with an amendment to make the Associated Alumnse 
the athliating body, as all the superintendents belonged individ- 
oally to iL After the annual meeting of the Red Cross in 
Drrember, 1900, the War Relief Board named the following 
Nfliii>iml Committee on lied Cross Kursiug IService> and Miss 
I>eia2M> was made chairman:^' 

FuoM War Relief Board 

Mrs. Whitelaw Reid, New York City; Mrs. Isabel Hamp- 
ton Robb, Cleveland, Ohio; Miss Jane A. Delano, Office of 

le Surgeon General, War Department, Washin^fton. D. C ; 

iss Ueorgia Xevins. Washington, D. C. ; Major Charles 
Lynch, U. 8. Armv. Washington, D. C; Surgeon W. L. Bell, 
IL S. Navy, Washington, D. C. 

From Emergency Reuef Board 

Mitt Mabel T. Boardman, War Department, Washington, 
D, C; Mrs. William K. Draper, New York City. 

XcHSEs' Associated Alumnje 

Miss Sophia F. Palmer, Rochester, New York ; Miss Emma 
M. Nichols, Boston City Hospital, Boston, Mass.; Miss Linna 
O. FtJchards<)n, Portland, Oregon; Miss Anna C. Maxwell, 
Presbyterian Hospital, New Y'ork City; Mrs. F. Tiee, Chi- 
cago, 111.; Miss Margaret A. Pepoon. San Diego, California; 
Mrs. Harriet Camp Lounsbury, Charleston, West Virginia. 

Jj^ier in Uvil Crofis flips. 

MinoCca, Wsr Relief Board, December 20, 1009. 



96 HISTORY OF AMERICAN RED CROSS NURSING 



The Afnerican Journal, of Nursing said editorially: 

By the appoiutment of this committee, with the majority 
of its members nurses, the responwihility of the nursing de- 
partment of the American National Hed Cross is placed upon 
the shouhlers of the members of the Associated Alumnae . . - 

So far, the nurses of the country' have not responded to the 
call for enrollment in the Red Crose as they should, the 
reason frequently given being that such a department under 
the direetion of laymen could not lie conducted on a practical 
working basis. This excuse can no longer be advanced, — 
the work of organizing a Jted Cross nursing senice is now in 
the hands of nurses. With the concentrated strength of all 
our national and local nursing societies it can be made a 
practical working force, . . . 

The action of the Associated Alumnoc brings the nurses 
of this country into distinct relationshij* with tlic War Relief 
Board and gives to them a very influential place in the ad- 
ministration of the strictly nursing side of the work of the 
National Red Cross. It is an opportunity which has never 
been ours and one which must receive the most intelligent 
cooperation from all the alliliated societies in order to prove 
our worthiness of the confidence which has been shown U8. 

After the meeting at Minneapolis, Miss l»Ano had gond 
abroad for a short trip but was suddenly recullod by receiving 
the appointment to the post of Superintendent of the Army 
Uurse Corps, as indicated in tlie list given above. Her selec- 
tion for this responsible work had l)een made on Miss Board- 
man's recommcndatiiin. The Surgeon General had gone thniugh 
Colonel Lynch to Miss Boardman for advice and she knowing 
that Miss Delano was then free (her mother having sonic time 
before passed away) and feeling confident of her ability, had 
counseled them to secure her if possible. Miss Boardman 
believed this appointment would unify the Red Cross and the 
Army Nursing work and Miss Delano shared this feeling, for 
she once said to Miss Boardman, "one of my reasons for taking 
this (the Army Nurse Corps") is my interest in Red Cross 
nursing and I believe the Army Nurse Corps and the Red Cross 
Cursing Service should work in harmony." 

The Red <'mss fiullctin of October, 1919, said of Miss De- 
lano's appointment: 

By this arrangement tlie whole system of the Regular 
Army Nursing Corjis and the Red Cross Nursing t'orps will 
be placed under one head^ so that in case of war the plans 



REOUGAMZATION AND AFFILIATION 



97 



for Red Cross nursing assistance will fall into complete ac- 
cord with the denmnds of the Army Medical Service. Miss 
Delano will, therefore, be not only fully advised as to the 
re;rular nursing strength of the Army Corps, but will know 
exactly the status of the volunteer aid of the Kcd Cross 
Nursing Corps. 

On a later occasion, when narrating the steps by which Miss 
I>t>ljuio went on to her long volunteer service in the Red Cross, 
\Lim Boardman resiled the incidents of that time. She wrote : 

... At the time of Miss Dolano*ii appointment to the Army 
Kurse Corj>s^ she was asked Ity the Kcd Cross to accept the 
chairmanship of its nursing committee. In consenting 
to do so iliss Delano said that one of the motives which in- 
fluenced her in taking the Army position was the opportunity 
it would give to bring about a close relationship between the 
Army Nurse Corps and the Red Cross Nursing Service. . . . 
At that time there were not more than twenty nurses report- 
ing reg\ilarly as members of the Army Nursing Reserve and 
Mi*« Delano concludt^d that the best way to secure an ade- 
quate number of rtist'ne nnri^^s was to do away with this 
branch of the Army Nurse Corps and to have the Ked Cross 
authorized to provide this service. Tlie Surgeon General 
agreed to her suggestion. . . . Devoting herself to the serious 
duty of reorganizing and improving the Army Nurse Corps 
Mi«s Delano quietly and carefully studied it. . . . The pay 
of the Army nurse was so low thiit it was impossible to obtain 
graduates of the best training schools and to correct this Miss 
Delano urged the increase of the pay in an Army appropria- 
tion bill. Tbe Surgeon General's otlice approved her sugges- 
tion and included in it an increase in the pay of the superin- 
tendent of the Army Nurse Corps, which was also inadequate. 
When this amendment was submitted to Miss Delano she 
promi>tly struck it out so that she should be untrammeled 

DV any apparent self-interest in her cfTorts for the benefit 

^^K of the nnrsc<«. 

^^P After two years as superintendent of the Army Nurse 

W Corjis Jliss Delano came to me one day and said: "I believe 

I now Uie time has come when I can give up my position in 

I the Surgeon General's oAk*. A very capable nurse, Miss 

I Mclsaae, will be appointed to succeed me. I have a little 

I means of my own and I would rather live on a crust and 

I wne the Red Cross than do anything else in the world. I 

I will gladly give my services to the Red Cross if it desires 

I them, to organize and develop its Nursing Department." 



98 HISTORY OF AMERICAN RED CROSS NURSING 



It was a very wonderful gift . . . there never was a gift 
given in a nobler spirit. . . ." 

Tho official corrcepondcnce touching Miss Delano's resigna- 
tion as head of the Army Nurse Corps follows ; 

War Department 

Office of the Surgeon General 

Washington 

March 11, 1D12. 
To Uio Surgeon General, 

United States Army, 
Sir: 

In accepting the position of superintendent of the Array 
Nurse Cor[>s 1 did &o in tlie hope of developing in connection 
with the American Red Cross an adequate nursing personnel 
which would in the event of war be available aa a reserve for 
the Army Nurse Corps. 

The organization of this nursing service is progressing 
moBt aatisfactorily, but in additinn to my duties as super- 
intendent of the Army Nurse Corps the work has grown be- 
yond my capacity. Believing that the maintenance of this 
Ked Cross reserve is as necessarj' to the Array as the Nurse 
Corps and that Ked Cross work should be as far as possible 
volunteer service, I have the honor to submit ray resignation 
as superintendent of the Army Nurse Corps, to take elfect 
April 1, 1912. 

My only object in resigning is that I may have the time 
to devote to the development and maintenance of an efficient 
reserve of lied Cross nurses for the service of the Army. 
Very respectfully, 

(signed) Jaxe A. Delano, 
Superintendent, Army Nurse Corps. 
lit Indorsement, War Department, Office of the Surgeon 

General » 
March 11, 1912. 

Respectfully forwarded to the Adjutant General of the 
Army, recommending that Miss Helano's resignation be ac- 
cepted to take effect April 1. I view with great regret Miss 
Delano's Boparation from the Medical Department of the 
Ami)'. She accepted the position of iJuperintendeiit of the 
Nurse Corps in August, 1009, with the understanding that 
she would remain in office for only sufficient length of time 
to put tho Nurse Corps on a thoroughly satisfactor}* basis. 
This she has done in an admirable manner. 

**Rfd Crow BuUetin, May 12, 1919. 



I 




REORGANIZATION AND AFFILIATION 



99 



VSlien she came to this office there were only 80 nurses on 
duty in i\\o Army Nurse Corps and there was no eligible 
list from which appointments could be made. In addition 
to thi? admirable work Miss Delano has had charge of the 
enntUnient of Hed Cross nurses and has now on her list 
n*arly 3,0U0 well selected nurses that will be available for 
Kfvice in the Medical Department in case of emergency. 

In view of the success which has attended Miss Delano's 
work &B superintendent of the Army Nurse Corps in pre- 
paring that organization to meet fully its obligations in the 
event of war, it is recommended that the Secretary of War 
in accepting her resignation place on record his appreciation 
of her serrices. 

(signe<l) Geo. H. Tohney, Surgeon General, U. S. Army 
Appro ve<l : 

By order of the Secretar}* of War, 

(signed) Leonaiid Wood, 

Major General 

Chief of Staff. 

Affiliation was now firmly rooted, but before following it 
further a brief final glance should be taken at the evolution of 
the Army Nurse Corps as part of Miss Delano's work. Mrs. 
Kinney had effected iiuprovcmcuts in the Army Nurse Corps, 
tiMngh in her timo the War Department had cut down very 
nuteriAlly on all expenses. She Imd gnim»d saloon mess for the 
DurMfl at sea and helped greatly in improving from the profea- 
sional and sixriul standpoint the position tlicy hud. 

She did, probably, as much as anyone could have done in those 
early months, but there was still progress to be made when Miss 
DibUdo took charge. The Surgeon General had planned a Nurse 
Reserve which he called the "Eligible Volunteer Corps," *^ but 
in this he had not been successful. Early in 1004, the Surgeon 
General had issued the following regulations, which the Journal 
of Nursing published. 

EuaiBLE List or Volunteer Nukses 

The Surgeon General has deemed it advisable to open in 
his office what shall be known as the Eligible List of Volun- 
teer N'urses. The names of acceptable graduate nurses who 
are willing to serve in time of war or national emergency 
will constitute this list and the requirements for enrollment 
shall be as follows: Applicants must have graduated from a 
trainiiig-schoul for nurses which gives a thorough professional 
* Amtricon Journal of Xursing, March, 1904. 



100 HISTORY OF AMERICAN RED CROSS NURSIVG 



education, both practical and theoretical, and which requires 
at least a two-years' residence in an acceptable general hos- 
pital of not lass than fifty beds. Graduatea from special hos- 
pitaU and from injfane asylums and private sanatoria will 
not be considered unless their training has been supplemented 
by not less than six mouths in a large general hospital. 

ApplicHtiou for enrollment must be iiimle to the Surgeon 
General and before being accepted the applicant must submit 
tn the following: (1) A statement of her physical conditicm 
filled out in her own handwritmg anil sworn to by a notary 
public. (2) A eertificate of her health from at least one 
reputable physician perstmally acquainted with t]ie applicant. 

(3) The name of her school and dale of her gra<luation. 

(4) A certificate concerning the moral, physical and pro- 
fessional qualitirations of the applicant as shown by tlie records 
of the hospital must be furnished by the superintendent of 
the training school from which the applicant graduated. If 
«he was trained under a former superijitcndent of nurses, 
her endorsement is also desirable. Blanks for these pur- 
poses will be furnished by the Surgeon General. 

Approved candidates will be placed on the eligible Hat for 
appointment in event of war or national calamity. 

Each nurse must agree to enter active service as she may 
be needed in time of war or national calamity. On the first 
of January and the lirst of July of every year she shall report 
to the Surgeon General, giving her address and enclosing a 
certificate from some reputable physician showing the con- 
dition of her health at that time. 

When called into active service these nurses will be sub- 
ject to all established rules and regulations and will re- 
ceive the pay and allowances of nurses of the Array Nutm 
Corps as set forth in General Orders No. 54, War Depart- 
ment, November IG, 1903, 

Nursc^fl did not enroll, however, in large numbers in the 
Volunteer Ctirps, In the S<>prcml»cr, 1005, issue of the Journal, 
Miss Pahncr, the editor, wrote: 

Another year is drawing to a close and at the beginning of 
August the '^Eligible List of Volunteer Nurses'' stands, since 
the first ap[H*al in March. 1004: number of applicants for 
blanks. 174. Of these (here have been returned 41* ; not recom- 
mended by her superinternlent. 1 ; total number on the list, 
41. Of these the number who have been or who ore at prescjit 
in Uie Army are 18, thus leaving tlie number of outside 
graduates on the list as twe.niy-three. If this means any- 
thing, it means that only foHy-one nurses out of over thirty 



REORGANIZATIOX AKD AFFILIATION 



101 



I 



I 



tbousami desire to serve their country in its time of need. 
But we know that if an emergency arose the nurses would 
rise to meet it anri we would have a repetition of the con- 
fusion and dissatisfaction which we were so ready to criticize 
and rebuke seven years ago simply beciiusc we are more 
selfish than patriotic. . . . 

Our faults are not the faults of nurses alone, for we only 
reflect the signs of the times and our own peo]jle, who love 
the glare of notoriety and excitement and are Hrkle and in- 
constant until misfortune and disaster overtake, when their 
inborn courage and faithfulness come to the front and save 
the day. Meanwhile we cry aloud, ^'How long, O Tjord, how 
long?" with this record of our iudilTerence standing as a 
public rebuke upon ns? 

Through Misa Delano's influence, the Red Cross Nursing 
Corps became the Army Nurse Iteserve aud the Eligible List 
of V^iluntwjr Nurses was tiually discoutinued. Miss Delano 
secured for the Army Nurse Corps additional pay; cumulative 
leave; lauudrv of uniforms; tirst-clusa transportation for all 
ntmes and improved quarters and in all of this ihu cooperation 
of the Red Cross had been most effective. 

MiBS Boardman has said that ifiss Delano*8 influence with 
officials of the Army was most marked. She gained their con- 
fidence by her »il)er, solid judgment and hv her willingness to 
oonfiider opposing viewpoints. She was usually able to get her 
recommeudations through. 

Her successor in tlic Am»y Nurse Corps, Isabel Mclsaac, was 
one of the most widely known and beloved nurses in the country. 
A grmduate under Isabel Hampton Uobb, of the Illinois Train- 
ing School, she had risen through every position there to the 
fupcrintendency ; had been prominent in all nursing associa- 
tiaxiSy had met thousands of nurses intimately as inter-state 
•ecrctarj' and had written popular textbooks. Very attractive 
in appearance^ with a personality expressing great sincerity, her 
Scotch ancestry was always evident in a certain dry and un- 
fjulini^ humor. Her views were broad and tolerant and her 
eommoQ senae amounted to a kind of genius. Miss Mclsaac 
threw all her gifts into the Array work and also her life, for 
she died "in ham*»s8" at the Walter Reed Hospital, Washing- 
ton, D. C, on September 21, 1914. 

A general reorganization plan was now issued from Wash- 
ington aa outlined in the following summary. It docs not seem 



102 HISTORY OF AMERICAN RED CROSS NURSING 



to have applied directly to nursing enrollment, but instituted 
the ''Chapter" which from now on becomes a familiar word. 

The Central Committee at Washington has found it neces- 
sary to make certain changes in the form of the state 
branches and iji a letter to these branches, under date of 
Xovembcr 1, 19U0, the reasons are clearly set forth. Briefly 
fltated, these are dintances which prevent representation fmm 
all parts of a state, with a tendency to concentrate officers 
and members at some central point, absence of state officers, 
jealousies, . . . conditions detrimental to tlie best interests of 
the Red Cross. Moreover, experience has taught that in 
case of disaster within the state the governor is the one who 
makes the appeal for assistance to the rest of the state, or 
to the President of the United States if national help is 
needed. Therefore, that the national headquarters with its 
active working force may be in immediate and close touch 
with all its branches when relief is needed, new regulations 
have been adopted by which local branches, hereafter to be 
called "Chapters" will be in direct communication with 
headquarters at Washington, retaining fifty cents on the an- 
nual dues, instead of twenty-five, for local use, and each 
Chapter may liave the privilege of sending one delegate to the 
annual meeting at Washington. The state boards will as- 
semble only in case of war or serious disasters. 

The charter, by-laws and regulations for state boards and 
Chapters have been issued under date of January 1, U»10, 
copies of which may be obtainwl from Major General George 
W. Davis, chairnuin Central Committee, American National 
Red Cross, Washington, D. C." 

At the first meeting of the National Committee on Red Cross 
Nursing Service, held on January 20, li>10, at the home of 
Mrs. VV. K. Draper, New York, Misa Delano's appointment 
was ratified and she was asked to take the chair. Miss Georgia 
Nevins, head of the Garfield Hospital, was appointed secrt^tury 
but as she was not present ^Irs. Draper was asked to act as 
secretary pro tern. Miss Delano then submitted the list of 
suggestions drawn up by her committee and herself: 

Outline of Plan for tlie Enrollment of Nurses Adopted hfj 
the National Committee on Red Cross Nursing Sernce. ' 

Duties of National Committee: 
To organize the nursing service of the Red Cross. 

"•Charter, By-Lnws, and ItogiiUlion* for State Boards and Chaptcra, 
Anierican K«<i CroBs, January I, 1910. 




EORGAKIZATION AND AFFILIATIOK 



103 



To make uniform rules for the enrollment of nurses 
throughout the country. 

To arrange for the establighment of state and local com- 
mittees on Red Cross Nursing Service, and to specify the 
duties of all such committees. 

To appoint annually state committees on Red Cross Nurs- 
ing Service of not less than five or more than ten nurses 
who are members of organizations alliliated with the NurKt's' 
Associated AlumnjE of the United Statep, but whore a state 
nurses^ association exists which is athliated with the Nurses* 
Associated Alumntt, appointments must be made from names 
^bmitted by the executive committee of such nurses' associa- 
tions. 

To issTie to local committees on Red Cross Nursing Service 
the uet^ei^bary blank forma for application of nurses for en- 
rollment. 

To HH-eive and file in the central otiice of the Red Cross in 
Washington the application blanks and required credentials of 
all Durties who have been accepted by local committees for 
enrollment as Red Cross nurses, and to issue cards of ap- 
pointment and Red Cross badges to all such accepted appli- 
ctnt&. 

To appoint, as headq\iarters, registries for nurses or other 
offices recommended by local committees as suitable places for 
tUiug li.stfi of enrolled nurses. 

To keep in the National office of the Red Cross in Wash- 
ington card catalogues of all state and local committees and 
of all headquarters for enrolled nurses with the approximate 
number of nurses available at each. 

To ascertain and keep on file the various sources of volun- 
teer service available, including Sisterhoods and members of 
other orders. 

To arrange for courses in home nursing, hygiene, and first 
aid under Uie direction of the Red Cross, utilizing as far as 
pciBsible for this instruction enrolled Red Cross nurses. 

To arrange for lectures on the relation of nurses to the 
Red Cross, and to encourage the presentation of the subject 
to graduating classes of nurses throughout the country. 

To study the nursing service of the Red Cross in other 
countries, with the object of improving that in America. 

In cooperation with the me<lical departments of the army 
and navv, to provide instructiou for curolleil nurses in the 
•poeia] duties which would be required of them in time of 
war. 

All matters relating to the services of nurses under the 
Red Cross will be referred to the chairman or secretary of 



10* HISTORY OF AMERICAN RED CROSS NURSING 



''^ 

t 



the Xational Committee of Nursing Service, and in coopen 
tiou with sxivh oUier members of the committee 
neces^ry they will be responsible for all a&signments of 
nurses to Juty^ and when two or more nurses arc sent out to- 
gether one shall be placed iu charge or authorized to act 
head nurse. 

Tiie National Committee on Re<l Cross Nursing Servi( 
shall hold regular semi-annual meetings, one in Washing- 
ton at tlie time of the annual meeting of the Red Cross, and 
the second at the time and place of the annual meeting ofjfl 
the Nurses' Associated Alumna?. ™ 

Special meetings may be held at any time at the call of 
the chairman. 

Fiili reports shall be presented at the semi-annual mecl 
ingfi 



IT 



Jake A. Deuano. 



The form of application, as prepared by Miss Delano s com- 
mittee "was subniittod and with one or two slight changes was 
approved, as follows: 

1. Name of applicant , 

2. Address 

3. Date of birth Place of birth 

4. Are you married, single or a widow? 

5. Are you a citizen of the United States? 

r». Have you any physical defects? 

7. Education and occupation before entering training 
school 

8. From what training scliool did you graduate? 

9. Is it connected with a general, special or private 
hospital ? 

10. How many beds in hospital at time of crraduation? 

11. Date uf graduation Length of course 

12. Name and address of superintendent under whom you 
were trained 

13. Of what nursing organization are you a member?,. 

14. Give name and address of secretary 

15. Are you a registered nurse? In what State?. . 

Date of registration 

16. How have you been employed since graduation?. . . . 
Give information for each year 

17. Give name and permanent address of nearest relative 

Signature 

Date 

" Americai^ Journal of Tiurtimg, Febniary, 1910, p. 303. 



1 
I 




nlfortn. (ETfty drenfl, brftSf^ard and cap, of an American Ked 

The dre«» uniform of ihe Nursing Servire coiiBiftta of a whit** 

rts white elioeft and tttuckiugs, the brasiukrd, Die cap and the 

ron. 



REORGANIZATION AND AFFILIATION 



105 



The chairman then prosentwl sug^stions to be filed as ref- 
erence for the applicants — this blank to be entitled '*Creden- 
tials from Training Schools." After a short dlscnssion of the 
above title, and one or two slight changes in the text, the blank 
vms accepted us follows: 



12 



Name of applicant 

Name of training school Address 

Date of graduation 

Length of course 

Number of beds in hospital during applicant's train- 
ing 

6. Character of hospital : 

General Special Private 

7. Are pupils sent out for private duty? 

8. What, if any, poeition of responsibility did applicant hold 
during her training 

Was her record satisfactory in regard to the following: 

Work? 

Ht>alth? 

Conduct ? 

Was she employed in your hospital after graduation? 
What has been her standing as a nurse and woman since 

fraduation ? v 
re you willing to recommend her for Red Cross 

Service? 

Superintendent of Training School 



9, 



Hospital 

Graduate of 

"Name and address of superintendent under whom the appli- 
cant was trained: 

Pemarks 

Date 

It was moved by Miss Palmer and seconded by Mrs. Kobb 
that the form of application and credentials from training 
•i;h*KiU Ik* adopted. These were as nearly uniform as possible 
iHth those used by the Government, so that in time of war they 
ttn be made immediately useful in the Surgeon Cienerars otficc. 

The rules governing the enrollment of nurses for service under 
the American Red Cross were adopted, as follows: 

1. All nurses enrolled for service under the American 
National Red Cross must have graduated from a school for 
ntmes which gives a thorough professional education^ both 



106 HISTORY OF AMERICAN RED CROSS NURSING 



theoretical and practical, and which requires a residence of 
at least two years in an acceptable hospital. In etates and 
territories where registration of nurses is required by law, 
graduates of schools not acceptable to Boards of Ilegistration 
will not be considered eligible for enrollment as Bed Cross 
nurses. 

2. All applicants for enrollment must be endorsed either 
by superintendents by whom tliey wore trained, or by a nurs- 
ing organization which is a member of, or affiliated with, the 
Nurses Associated Alumna' of the United States ; or must 
submit such other evidence of moral, profesfiional and mental 
qualifications as may be required. 

3. All enrolled nurses shall receive a physical examina- 
tion before being assigned to service, if required, — such ex- 
amination to be made at most convenient point by a physician 
authorized by the Eed Cross. 

4. No nurse under twenty-five years of age shall be en- 
rolled for active service. 

5. All nurses called on for service in time of war will be 
required to take the oath of allegiance. 

Mrs. Robb moved that this committee recommend that the 
Red CroflB Nursing Corps enroll for paid service. This motion 
was seconded by ilisa Nlclicda, and after a short discussion was 
carried. 

The plan for carrying on the work of enrollment was then 
discussed by the committee and the following motion made hy 
Miss Cooke and seconded by Miss Palmer was unanimously 
adopted : 

That the Central Committee on Red Cross Nnrsinj; 
Service should ask each State Nurses' iVssociation to instruct 
their executive committee to appoint a Red Cross committee, 
of not less than five members, to organize local conmiittees 
throughout the State for the purpose of enrolling nurses. 
The local committees to be seven in number — five nurses 
and two lay members, representing tlie local Red Cross ; thesa- 
committees to have charge of enrollment. The applicatioa 
blanks and credentials of the nurses, as accepted by this com- 
mittee, to be sent to Washington for filing; and a card cata- 
logue, giving the name, address, telephone number, school 
of graduation and dote of graduation to be kept by the local 



d 



01 graauaiiou ana aoie oi graduation to m Kept oy tne Jocai^j 
committee for reference — the local committee also having thi'^H 
responsibility with the approval of the State Nurses Red^^ 
Cross Committee, for arranging with some registry, training 
school or office to take charge of thejte cards, and be respon- 



REORGANIZATION AND AFFILIATION 



107 



Bible for the immediate notification of these nurses in case of 
an eniergeucy call. 

AMERICAN NATIONAL RED CROSS 

Branch*' 

19 

On recommendation of the Committee on Nurses of the 

Branch of the Amcricnu National Red Cross 

jour offer of service is hereby accepted for assignment to duty 
when and where your services may be required. 

NMien assigned to duty your compensation will be at the 
rate of forty dollars per month wlien on duty in the United 
States and fifty dollars per month when without the limits 
of the United States, in addition to transportation and sul>- 
eistence. 

This acceptance to hold until your services are no longer 
reqoiredy or oxntil your resignation is accepted. 
Very respectfully, 



President Branch," 

American National Red Cross. 



To, 



The correspondence between Miss Delano and her co-workers 
It that time ttHjJus with suggestionH and countor-auggestions. 
The letters arc full of interest and many tempt one to in- 
clude them, but their length precludes all but brief illustrative 
examples. 

Ifr*. Helen F. Draper to Miss Delano: 

I agree with you that as a general thing it is wiser to 
Hmit the number of persons to serve on a committee. Tn this 
particular instance, however, where we are not starting out 
on a new basis, bxit reorganizing a former plan, I think that 
local conditions have to be taken into consideration. It would 
seem to me wiser, as in Brooklyn and New York, to continue 
the former committees as fnr as possible. I therefore think 
that TOur suggestion in regard to State Committees is good — 
*lt shall be the duty of the National Committee to appoint 
State Committeefi nf at Icnpt five nursos who are members of 
organizations aftiliated with the Nurses' Associated Ah^mnie, 
hot where a State Nurses* Association exists these appoint- 
*MJDat««, KaI. Com. on lUs] Cross Xuraing Service, January 20, 1010. 



108 HISTORY OF AMERICAN RED CROSS NURSING 

ment8 must be ma<le from names submitted by the executive 
4'nirinntU'e of sufh State Nurses' Association/' I, also, agree 
to the sug"^ostion in regard to the appointment of local Red 
Cross committee by the State Committee on Nursing Service. 
In reirard to the annual appointment of committees, I 
think if tliif- is done, it should be done only with the idea that 
two mpmhcrs only should eome up each year. I would per- 
sonally prefer a permanent — but if the majority of the Cen- 
tral Committee on lletl Cross Nursing Service feel that a 
varying tjomuiittee is wiser, 1 would be willing to vote for one 
where two members were changed each year. 

The manifold details of bringing atliliation plans into shape 
and of uniting on some definite lines of activity for pt^uce 
times are suggested in the following letter from Miss Delano 
which touches on all the problems then pressing for solution. 
Of these one of the most sigiiiticant was that already mentioned 
as having arisen in lt)OS, of carrying iustructiou into the homes 
of the people. 

March 15, 1910. 
My dear Mrs. Draper : — 

At last we have the first installment of the Red Cross matter 
ready, and it seems to me that it would be possible to begin 
on the formation of the State Committees while we are at 
work on the other dat^i. In the meantime the State Com- 
mittees can be planning out their work and locating the 
branches. After talking the matter over a number of times 
we decided that it wouUJ be better to publish all the data in 
a little book about the size of the Constitution of the Red 
Cross so that every one interested will know all of the steps 
from the duties of the National Committee down to the actual 
enrollment of nurses. Miss Boardman thought that it would 
be well to have a little outline of the Red Cross at the be- 
ginning and the circumstances leading up to the affiliation 
of the Nurses' Associated Alumna?, which accounts for tlie 
little **foreword'' 1 am sending you. Some changes may be 
necessary in the ''duties of the National Committee/' and we 
hope you will criticize and suggest any changes you think 
necessary. After much discussion and many letters it seemed 
wise to leave the size of the State Committee with the various 
States. Do you approve of the paragraphs relating to '"sources 
of volmiteer service," **the courses in home nursing," 
"hygiene," *'first-aid" (these were among Mrs. Robb's sug- 
gestions) and provision for lectures on lied Cross subjects? 
Misa Boardman wished to leave the matter of assignment of 



REORGANIZATION AND AFFILIATION 109 



to at'tivt! duly to Uie National Committee, and the 
iph referring to this was added at her request. . . . 
talking with Miss Boardman and Miss Kevins in regard 
to Uic appointment of the committees it was sugget?ted that 
it would be alnioi^t impossible to keep track of the members 
going out at varj-ing periods where there are so many com- 
initt«<es to consider. The idea of the annual appointment was 
thatf as a matter of course, all members of the Committee 
should be reap[K)inte<1, unless for some reason it seemed best 
to make a change. If we make any provision for reapj)oiDt- 
ment with so many permanent connnittees all over the coun- 
ti7, there fleem.s more or less danger of having a certain 
ooznber of inactive people on the committees with difficulty 
in regard to placing them. This would make it possible to 
reappoint all of the committee, if desirable^ or to make 
changes without hurting anyone^s feelings. 

To the reference in this letter to the home nursing plan Afrs, 
Draper replied with suspended judgment, as she thought it was 
too soon to branch out in new directions. What the subsequent 
developments of this department were wiU be dealt with in a 
special section. 

In April, 1010, Isabel Hampton Kobb was suddenly removed 
tjdeftth from the manifold activities in which she took so eager, 
ia tonic and inspiring a part. In the American Journal of 
NwmMg of May, we read : 

The filiook of her death ia so great tliat it seems impossible 
yet to collect one's thought surticiently to look back over her 
long service to the nursing profession — she was still in close 
touch with all its activities. One cannot think of a move- 
ment of im(»ortanee of which she was not one of the moving 
spirits, organizer, supporter; the Superintendent's Society, 
of which she was president only last year; the Associated 
AJamuof. of which she was president for the first five years 
and at whose meetings she was almost always present; tlie 
Journal the course at Tenchers College, of wliich she was 
one of the lecturers; the International Association to which 
she was a delegate last summer ; the Red Cross, of whose 
Central Committee she was a member. All of these will miss 
ber aadly. 

The Minutes of the Central Committee said of her: 

We record with much sorrow the tragic death of Mrs. 
Isabel Hampton Robb, a most valuable niemhor of the War 
Relief Board and of the sub-committee on Red Cross Nursing 



110 HISTORY OF AMERICAN RED CROSS NURSING 



Servic-e, a woman of large insight, warm sympathies and 
broad experience, to whom we are indebted more than to any 
other ])erson for the devi'Iopment and perfection of nursing 
organizations whidi has made the work of this committee 
posaible. 

By early snnimer Sfiss Dtlano presented the following en- 
couraging report on afhliation and enrulhnent; 

AMtiiticAN Kku Cuobs Notes 

The National Committee on Red Cross Nursing Service 
announrL'S M'ith pleasure the completion of the plan for the 
enroHuient of Hed Cross nurses. The first step necessary 
is the formation of State Committees on Red Cross Nursing 
Service in accordance with the following provisions. 

"The National Committee shall appoint State Committees 
on Rod Cross Nursing Service of not less than five nor more 
than ten nurses who are members of organizations af^liated 
with the Nurses' Associated Ahinina^ of the United States, 
but where a state nurses' association exists which is affiliated 
with the Nurses' Associated Alumna? appointments must be 
made from names subnuttetl by the executive committees 
of such state nurses' associations. Unless changes in personnel 
become necessary, it is desirable that a majority of the mem- 
bers of State Committees be reappointed annually." 

The following State Committees on Red Cross nursing 
service have already been appointed. 

West Virginia: Mrs. H. C. I^unsbury, Charleston; Mrs. 
Mary G. Cari)enter, Wheeling; Miss Vernon, Fairmont; M. 
Virginia McCune, Martinsburg; Mrs. M. Liugenfelter, 
ninton. 

Illinois : Adda Eldredge, cliairman, (^hicago ; Man,- ('. 
Wheeler, Quincy; Adelaide M. Walsh, Chicago; Ellen Par- 
sons, Chicago; Mrs. Tice, Chicago; Helena M. McMillan, 
Chicago; Bcnna M. Henderson, Chicago. 

New York: Klizubeth Dewey, chairman, Brookl}*!!; 
Beatrice V. Stevenson, Brooklyn; Mrs. C. V. Twiss, New 
York City; Elsie Patterson, New York Citv ; Anna Charlton, 
New York City; Mrs. Ernest O. H. ScKenck, New York 
City; Mrs. Harvey D. Burrill, S3Tacuse; Sophia F. Palmer, 
Rochester; Marie T. Phelan, Rochester; Rye Morloy, Buffalo. 

To facilitate the formation of these committees the follow- 
ing states have been assigned to members of the National 
Committee and state secretaries are earnestly urged to com- 
municate with their organizing member of tho National Com- 
mittee for information and advice. 



I 




K 



REORGANIZATION AND AFFILIATION 111 

Emma M. Nichols. Boston, Ma8s., Maine, New Hampshire, 
Vermont, Massac-JiUi^eUs, Hhode lulaiid, Connecticut. 

Aana C. Maxwell, New York City^ New York and New 
Jersey, 

Georgia M. Nevins, Washington, D. C, District of Colum- 
bia and Maryland. 

Mrs. H. C Lounsbury, Charleston, W. Virginia, West Vir- 
ginia, North Carolina, South Carolina, Georgia, Kentucky 
aiid Tennessee. 

Mrs. Frederick Tice, Chicago, Illinois, Michigan, Iowa, 
Minnesota, Missouri, Arkansas. Louisiana. 

Linna G. Richardson, Portland, Oregon, Washington, Ore- 
^Q, Idaho, Montana, Wyoming. 

&tarj^rct A. Pepoon, San Diego, Calif.^ California, Nevada, 
Utah. Arizona. 

States unassigned will communicate directly with the 
Cliairman of the National Committee on Nursing Service, 
State, War and Navy Building, Wiii^liington, D. C. 

(signed) Jane A. Delano, 
Chairman National Committee 
on Nursing Service.'* 



States which were sot yet organized were summed up thus 
bj Ififls Delano: 

To mj'self, as chairman of the Committee, came the 
mother's share, oil thoee etates which did not seem to fit 
in any locality, many of them without state organizations, I 
am sorry that 1 am not able to show a better report of my 
own work. 

PennsA'lvania ha? begun its organization. Delaware has 
not been communicated with. Mrs. Lounsbury is going to 
consult with Virginia to bring about an organization, while the 
dele^tes are here. Florida has no state organization. Texas 
is at work and I hope will very soon be organized. North 
I>akota and South Dakota have no state organizations. 
Nebraska has, and has a delegation here, and we hope to have 
something done before it goes back. 

Kansas has no state organization. Colorado has. New 
Mexico has none. Alabama has none. MisFissippi has none. 
Ohio is organized with Miss Johnson, who is in charge of the 
district nurses in Cleveland, as chairman. Indiana is or- 
gam'zed with Miss Elizabeth Johnson of Indianspolis, chair- 
man. Wisconsin, one of the two states admitted this session, 
IB organized. With true western spirit they had their com- 

*Am9ri€mm Jpumal of Xurning, Mny, 1D10, p. 509. 



112 HISTORY OF AMERICAN RED CROSS NURSING 

mittee all appniiik*! in case thpy were accepted, so there 
was very little trouble, and Miss Matthews is chairman. 

I think yon will a^rcc with me that this is a good showing 
for a very few weeks' service. 

Within a couple of months the results of the labors of the 
National Committee members to whom had been entrusted the 
sections of the country above named, were recorded in Miss 
Delano's notes, together with an outline of her own coast-to- 
coast tour of speech-making before audiences of nurses. She 
wrote: 

The response from various sections of the country has 
been most gratifying and already the following State Com- 
mittees have been appointed and are at work organizing Local 
Committees: Alassachusetts, chairman, Mary M. Riddle; New 
York, chairman, Elizabeth Dewey: District of Columbia, 
chairman, Anna J. (Trcenlees; Marj'Iand, chairman, Mary C. 
Parkard; West Virginia, chairman, Mrs. H. Camp Louns- 
bnry; Georgia, chairman, Mrs. A. C. Hartridge; Tennessee, 
cbairman, Lena A. Warner; Illinois, chairman, Adda Eld- 
redge; Michigan, chairman, Mrs. L. E. Gretter; Iowa, chair- 
man, Helen Balcom; Louisiana, chairman, Emma L. Wall; 
California, chairman. Moselle Richie; Oregon, chairmaa, 
Jennie V. Doyle; Ohio, chairman, Matilda L. Johnson; In- 
diana, chairman, Elizabeth Johnson; Wisconsin, chairman, 
Stella S. Mathews. . . . 

The following letters show how the work of tying up State 
societies of nurses with the Red Cross was completed : 

December 2, 1910. 
General George H. Torney, Chairman, 
of the War liehef Board of the 
American Red Cross, 
Sir:— 

In accordance with the provision of the By-Laws of the 
American Ked Cross, Article 15, paragraph f, page 21, which 
reads as follows: "Societies of Nurses. The Central Commit- 
tee shall have authority to establish a class of membership into 
which may be invited permanent State or Territorial so- 
cieties of nurses. When accepted into membership by the 
Central Committee any such society shall be entitled to dele- 
gate representation in the annual meeting of the American 
Red Cross under terms and regulation prescribed by the 
Central Committee," — I woiild request, as chairman of the 
Committee on Red Cross Xursing Service, that membership 




REORGANIZATION AND AFFILIATION 



113 



be allowed all State Nurses' Associations organized for the 
cnrollineDt of Red Cro»s nurses. 

If this suggestion meets with the approval of the Central 
Committee of the American Red Cross, the following State 
Nurses' Asetociations would be eligible for membership: 
California; District of Columbia; Georgia; Illinois; Indiana; 
lova ; Ijoui.-^iana ; Maryland; Massachusetts; Michigan; Ne- 
biBfilu; New Jersey; New York; North Carolina; Ohio; 
Orcjgon; Pennsylvania; Tennessee; West Virginia; and Wis- 
oonsixL 

Very respectfully, 

(Jane A. Delano) 
Chairman, National Committee on 
Red Cross Nursing Service. 

December 5, 1910. 
To Misa Delano: 

. . . That the plan in general, as outlined in report sub- 
mitted by the Chairman of the Subcommittee on Red Cross 
Nursing Service, is approved and the Chairman is requested 
to transmit the same to the Central Committee for its con- 
HidtTAtiou ami action. 

(signed) 

TOBNEY, 

An example of the letters sent throughout the country ia this 
^«ooof Mrs. Lounsbnry. 

The Auerioan National Red Cross 

Washington, D. C. 

National Headquarters, 

Boom 341, State, War and Navy Building 



President Stale Nurses Association. 
DearM 

The National Red Cross Nursing Service has been thor- 
oughly reorganized, and is now ready to receive the names 
of nurses who wish to be enrolled for service. The plan of 
the National Committee is to enlist the active sympatny and 
oM^ratioD of the presidents of the State Nurses* Associa- 
tioos and through them to reach the individual nurses. 

You are cordially invited to assist in this great work, and 

to art as the distributing center for . 1 enclose a 

bodclet containing the rules and regulations for the Ameri- 
can Bed Croes Nursing Service, and sample copies of the 
application for enrollment, the card for filing in Washington 



114 HISTORY OF AMERICAN RED CROSS NURSING 



and the card for the endorsement of appli<»ant8 by State or 

Alumnie Society. 

Will you kindly let niG know if you will assist us in this 
great work, which seeks to place in the bauds of the Re<i 
Cross in Washington the names and addresi^es of graduate 
repistrrcd nurses, who can be called upon in time of war or 
national calamity. 

Will you send me the names of four responsible nurses of 
who will assist you, acting us a State Committee? 

An early reply will be much appreciated. 
Sincerely yours, 
(signed) IlAitHiET Camp Lounsbuhy, R N. 

MbS. OEOnOE LOUKSBCBY. 

We miist pass over Miss Delano's trips to the West in the sum- 
mer of 1010^ primarily to inspect the Army Xurse Corps. It is 
more relevant to give, here, some glimpse of how the Red 
Croaa cnrollniont went on, as recorded by Mary A. Clarke in 
her personal recollections of Miss Delano: 

On her return to Washington about December 1, 1910, she 
asked me to come to assist her in the work of enrollment. . . . 
Miss Delano was just getting settled in a cozy home. . , . 
She wafi essentially domestic in her tastes. . . . The Ameri- 
can Kcd CruHH oiric*c8 were then in the State, War and Navy 
Building, but Miss Dclann» expecting to do her Red Cross 
work before njid after her day at the War Department, made 
her oHice in her home. 

Her largest room was fitted up for Red Cross work. . . . 
AppIicatiouB and letters were gone over ilaily. A vast num- 
ber of typewritten letters of instructions and^large packets of 
circulars were sent east and west, north and south. . . . Every 
application was carefully gone over, first by me and then by 
Miss Delano. . . . 

When the nursing Bervlce was reorganized it was found that 
about 950 nurses had been enrolled under the old dispensa- 
tion. Through the Jminuil Miss Delano sought to locate 
them all, list names and addresses, number of their badges, 
date of enrollment and ascertain how many were still available 
for service. . . . 

Steadily as time went on, qualifications for enrollment be- 
come more stringent. Training schools everywhere were 
anxious to come up to the requirements, some insisting upon 
more extensive preliminary education on the part of their 
applicants, others lengthening their course of instruction, and 
some superintendents adding beds to the hospital's former 
capacity in order to meet tlie fifty-bed requirement • . . 




REORGANIZATION AND AFFILIATION 



115 



It was soon evident that the more the enrollment of nurses 
waj? restricted the more eager nurses were to join. By July, 
1911, applic'atians were coming in at the rale of 200 a 
month. . . . 

Miss Delano was single minded in her determination to en- 
roll only those women who. in addition to professional effi- 
ciency were well recommended personally both by the hospital 
auperintendent and the president of the nhimuae associa- 
tion. . . . She was tenacious of her point aa to the personality 
of the nurse because she felt that the women chosen for Reil 
Cross nursing must be of such uprightness of character, 
purity of life and good judgment, that they could be relied 
on to do the discreet and right thing wherever placed.** 

The home-loving phases of Miss Delano's many-sided per- 
ionality, to which Miss Clarke made reference, were further 
dtecribi^ by a dose friend who later made her home with Miss 
XMano: 

I grew to love her dearly, not only for her goodness to me 
but liecause of her personal charm, her interest in all that per- 
tains to home life, her love of animals and flowers, her almost 
ehild-Iike enjoyment of tlie simplest pleasures. A strong sense 
of humor carried her through many trying situations and 
she loved both to hear and to tell a good story. She was 
rarely idle, rest to her meaning only change of occupation. 
She worked deftly and swiftly, making every moment count, 
tnd she played, when not overburdened as in the last year, 
with the same thoroughnc-^s. An excellent housekeeper in 
method? familiar to New England, she was interested in the 
smallest details of her household. ... It was a pleasure to 
watch the motion of her hands, they were so capable and 
efficient. She was very orderly as to her belongings, but at 
the same time delightfully inconsistent, for she would allow 
her fwt dog to take liberties which to most people would have 
been annoying, lie adored her and from the moment her 
car turned into our street he was at the door with a rapturous 
greeting. 

She professed to have forgotten how to nurse, yet I shall 
never forget an illness when she carried me bodily to her 
home, put me to bed and cared for me herself with wonderful 
tenderness, skill and resourcefulness. . . .'^ 

Tu January IHll Miss Delano began writing the Red Gross 
Dcp«rtxnent of the American Journal of Nursing, a responsi- 

■ MpTit'irandum in Red CroM Archives. 
'C. AL Nrvin», American Journal of Xuraing, Vol. 19, p. 699. 



116 fflSTORY OF AMERICAN RED CROSS NURSING 



bility which she carried until her death, 
wrote: 



In her first notes she 



I 



At a meeting of the Central Committee of the American 
Red Cross held on Monday, Decemlier 5, 1910, the following 
resolution wqk adopted : fl 

That each State or Territorial nurses' association organized ™ 
for the enrollment of Ked Cross nurses be admitted to mera- 
berehip in the American Ked Cross with the right to send a 
delegate to the annual meeting. . . . 

[The names of the states admitted to membership foUowed; 
they have already been given.] 

We will cn)ntine this report more especially to the activities 
of the Committee on Hed Cross Nursing Service. The im- 
portance with which this work is cnnsitlered is shown by the 
oflicial report of Surgeon General Oeorge H. Toruey," chair- 
man of the War Relief Boarrl, which was read at the annual 
meeting and from which wc quote the following: 

"Probably the most important accomplishment of the War 
Relief Board during the year has been the organization of 
two departments, the First Aid Departmuiil and the Nursiug 
Department. It was realized that the importance of these 
two classes of work had become so great ami demanded such 
close supervision that it was essential that two departments 
be created. The wisdom of this decision has been proved 
by the outcome. The work of the First Aiil Departujent and 
of the Nursing Department will be described by their re- 
spective chairmen. I feel, however, that I can allude to 
the importance of the work of these departments with more 
grace than can these chairmen." . . . 

Since some of our nurses ran be relied upon only for or- 
cranization work, and realizing the importance of this, either 
in time of peace or in the event of war, it was resolved "that 
all nurses, members of Red Cross Committcep, be asked to 
enroll even though unable to respond to a call for active 
service. 



The first suggestion of Rural Nursing was made in 1910 at the 
annual meeting: 

A letter from Miss Wald to Mr. Schiff was then read by 
tlie chairman. Miss Wald set forth the needs of the rural 
communities for nursing and wished to know if the Red 
Crosa might not consider taking up such a work. While the 
fact was recognized by the Committee that effort should be 
made to keep up the interest of enrolled nurses, it was thought 
that preparation for Mar, and emergency work in the form 



I 
I 



I 




REORGANIZATION AND AFFILIATION 117 

of lectures from army officers, if possible, and later perhaps, 
the formation of home nursing classes, were preferable to 
any other nursing work by the Ked CroHs at present. 

Mrs. Drajwr strongly urged tliat the Red Cros? direct Its 
attention for sonie time to como to the subject of thorough 
organization. Mrs. Tice move<l tliat a committee including 
Mrs. Draper, Mr. and Mrs;. Glenn, and Mias Maxwell be ap- 
pointed to confer with iliss Wald. This was carried. 

Mrs. Draper then brought up the question of assistance 
to the chairman of the Kcd Cross Nursing Service. The small 
office of the superintendent of the Army Nurse Corps was 

rholly inadequate and she was no longer able to do the con- 
itly increasing work of this committee unaided. Major 

jiiTich moved that the Red Cross be asked to appropriate a 
sum not exceeding $1200 annually for salary of a clerk and 
room rent. It was carried. 

A pap<*r was read at the same meeting on the **Cor»rdination 
of Social Agencies," by Annie Laws, secretary of the Cincin- 
xuti Chapter* Mias Laws, as Miss Wald had done, brought 
larger social problems forward. She said among other sug- 
gestive things: 

rThc question has arisen in the minds of many as to whether 
the great American Re<l Cross, pledged to help humanity 
in so many directions, might not extend its fostering care, 
through the visiting Red Cross nurses, to others needing help 
quite as badly as tuberculosis patients, in some cases more. 
Also, whether the fact that the Red Cn)s.s with its insignia 
being so absolutely identified at Christmas-time with a more 
limited organization, and yet being brought so prominently 
forward, does not tend to confute the minds of many people 
and obscure the larger significance of the Red Cross, and 
make it appear oa an adjunct rather than as the great inter- 
national and national emblem. . . ." 

This paper and Miss Wald's letter contain the initial sugges- 
tions of important subsequent work of the Red Cross for public 
health which will form the subject of later chapters. 

The year 1911 saw the first movement of the United States 
troops since the Red Cross Nursing Service had come into 
exiatencit and Miss Delano said in her Journal notes; 

All Re<l CrosH nurses will be interested in the mobiliza- 
tion of 20,000 United States troops on the Mexican frontier, 

■R^rporl of the Annual Meeting of the Red Crosa Kuraing Servioe Com- 
mitter. December 7, 1910. 



118 HISTORY OF AMERICAN RED CROSS NURSING 

and over 2000 marines in the Gulf of Mexico, for never before 
in the history of the rountry has such a large botly of sokliers 
been brought together in time of peace. , . . Should a sud- 
den need for nurses arise, there stand ready to cooperate with 
the National Committee on Red Cross Nursing Sernce, 141 
nurses on 24 State Red Cross committeeti. and 233 more on 
local committees. These c^jmniittees, with nearly 1300 en- 
rolled nurses, are a guarantee to the nation that neither the 
stress of calamity iior the turmoil of war will ever again 
find us wholly unprepared. 

The National Committee on Red Cross Nursing Service 
has in contemplation n plan for providing inhtructive lec- 
tures to be given by medical officers of the army to assemblages 
of nurses in different parts of the country. Two of these 
have already been given by Colonel L. M. Maup. Chief Surgeon 
of the Department of the Lakes; one in Illinois, the other in 
Wisconsin, at the meeting of their respective State associa- 
tions.** 



A letter to ^frs. Heid from Alis-s Dcbino at this time gives a 
personal touch to the activities of each : 

May I thank you for your most generous contributions 
toward the work of the National Committee on Red Cross 
Nursing Service and tell you s^jmething of what has been ac- 
complished during the past year: — . . . 

We have a si>ecinl Red Cross Department in the Journal 
of Nursing, and the interest shown by nurses all over the 
country is most gratifying. We send to each nurse enrolled 
the usual badge and an appuintnicnt card like the enclosed, 
which is really a card of identification in case the badge is 
lost. I am sending by separate mail copies of our various 
blanks, which may be of some interest. 

I have been hoping all winter that we cnuUl arrange for a 
reception for enrolled Kcd Cross nurses in Roston at the time 
of the meetings of the Associated Alumnie in June, and 
just when I was wondering how it i-ould be managed your 
contribution came tlirough Mrs. Draper. Nothing, 1 am 
sure, would more stimulate interest in our Red Cross work 
than bringing the enrolled nurses together. I have talked 
this over with Mrs. Draper and Miss Boardman and they 
both feel sure that you would ajiprove of our using a por- 
tion of this last contribution for the expeua»s incurreil in 
giving lids reception. We will send an invitation to each en- 
rolled Hed Cross nurse in the United States (we bave now 

*^ Amrricon Joumnt vf Vwrtfin^, April, 1011, p. 537. 



I 




REORGANIZATION AND AFFILIATION 



119 



Dearly 1600), aud hope that many of the Alumnte Associa- 
tions may send thorn as delegates to the Boston meetings. 
Mrs. Draper, Miss Boardnian, Major Lyn<'h of the Army and 
Dr. Elliott of the Navy have all promised to aseist in re- 
ceiviup, aud Major Lynch has suggested that we invite all 
the physicians in Boston who are on the Army Medical Re- 
serve list. 

It watt Buggesteil at the meeting of the Associated Alumnas 
last year that it would he a groat advantage to have a well- 
known nurse attend the various meetings of State Societies, 
Alumna? Associations, etc., and speak to the nurses in regard 
to the purposes of our larger organization, the educational 
value of the Journal of Nurtnng, and the responsibility of 
individual nureos toward the Red Cross. We selected Sliss 
Isahel Mclsaac, for many years superintendent of the Illinois 
Training School for Nurses, for this work. She was em- 
ployed for six months, receiving $100.00 a month, and made 
a complete tour of the various states. All of her traveling 
expenses were met by the nurses themselves, leaving only her 
italary of $*tOO to be shared by the Amcncan Journal of Nurs- 
ing, the Red Cross and the Associated Alumnse. Your con- 
tribution of last year made it possible for the Red Cross to 
do its part, and I feel .sure that we have been more than 
repaid by the interest aroused in all sections of the country. 

This is a hopelessly long letter, but I am sure you will for- 
give me, for I feel that 1 must tell you again how thankful 
we are for your interest and help. To have your name on 
the Committees means much, and 1 really want you to know 
just what progress wo are making. 
Believe me, 

Yours sincerely, 

(signed) Jane A. Delako. 

The Jnnc Meeting of the Associated Alurana? in Boston, 
lOlly WM made a special Itcd Cross nursing event. A HoA 
Groas reception was held at the Hotel Brunswick, and letters 
of greeting and congratulation were read. Dr. Torney wrote: 

War Department, 
Office of the Surgeon General, 
Washington, D. C, May 25, 1011. 
Bear Miss Delano: 

It is with great gratification that I learn that nearly 2000 
nurses ha^e enrolled in the Red Cross Nursing Service. The 
Medical Department always looks upon these nurses as its 
reserve in time of war, and this large enrollment is the mos-t 
encouraging information I have received in a long time with 



120 HISTORY OF AMERICAN RED CROSS NURSING 



reference to our efforts to prepare the Department for its 
work in time of emergenry. 

I hope you will take occasion at your Boston meeting to 
express my appreciation of the patriotism shown by the State 
and Local CommiUees and the nurses throughout the country 
in respondng to the call to join the Red Cross Nursing 
Service. 

With a large enrollment of Red Cross nurses^ the diffi- 
culties that have been experionoed by the Medi(^l Depart- 
ment in obtaining a suitable nursing service will be im- 
possible in the future. 

)iiflB Delano wrote, after this meeting: 

Nothing has so stimulated interest in the Red Cross as 
the bringing together of Red Cross nurses from different sec- 
tions of the country during the meetings of the American 
Nurses Ai^sociation. 

In August, 1911, the President issued a proclamation relat- 
ing to the Rod Cross service. Its text follows : 

By the President of the United States. 
A Proclamation. 

WHEREAS, the American National Red Cross having been 
incorporated by an act of Congress, January 5, 1005, **To 
furnish volunteer aid to the sick and wounded of armies in 
time of war, in accordance witli the spirit and conditions of 
... the Treaty of Geneva of August 22, 1861," and 

WHEREAS, it is desirable definitely to state the relations 
that shall exist between the American National Red Cross 
and the Military departments of the government in event of 
war: 

NOW, THEREFORE, I, WILLIAM H. TAI?T. Presi- 
dent of the United States, by virtue of the authority in me 
Tested, do hereby declare and proclaim — 

1. That the American National Red Cross is the only vol- 
unteer society now authorized by this government to render 
aid to its land and naval forces in time of war. 

2. Tliat any other society desiring to render similar as- 
sistance can do so only through the American National Red 
Cross. 

3. That to comply with the requirements of Article 10 of 
the Internntinnal Red Cross Convention of 11*06 (revision 
of the Treaty of Geneva), that part of the American National 
Red Cross rendering aid to the land nnd naval forces will 
constitute a part of the sanitary serviwe thereof. 




REORGANIZATION AND AFFILIATION 



121 



4. That if it should be desirable in time of war, or when war 
is imniiuent, for the War DcpartniPiit or tho Na\T Depart- 
ment to make use of the services of the American National 
Red Cro88, the Secretary of such Department is authorized 
to communicate with the Prenident of the Society, specifying 
the character of the servicen required, and designating the 
place or places where the personnel and material will be as- 
sembled. 

6. That when any member of the American National Red 
Cross reports for duty with the land or naval forces of the 
United StatoiS, pursuant to a proper call, he will thereafter 
bo subject to military laws and regulations as provided in 
Article 10, of the International Red Cross Convention of 
1906, and will be provided with the necessary brassard and 
certificate of identity. 

6. That except in cases of great emergency the personnel 
of the American National Red Cross will not be assigned to 
duty at the front, but will Xm confined to hospitals in the home 
country, at the base of operations, on hospital ships and along 
lines fif commnnicatiou of the military and naval forces of 
the United States. 

IN WITNKSS WIIKREOF I have hereunto set my hand 
and caused the seal of the United States to be affixed. 

Done at the Cit)* of Washington, this twenty-second day of 
August, A. D. one thousand nine hundred and eleven, and 
of the Independence of the Unite<l States of America, the 
one hundred (Seal) and thirty -sixth. 

Wsr. H. Taft." 

MiBS Delano's notes in October return to the educational 
outlook: 

It is with much gratification that we announce the forma- 
tion of Red Cross Committees in \i\\ states having a State 
Nurses* Association with the exception of Idaho, Oklahoma, 
South Carolina and Wyoming. It is hoped that before the 
next month's issue of the JournaJ we may welcome these 
states to ttur National Branch of this world-wide work for 
humanity. . . . 

This makes in all 31 State Committees, while our Local 
Committees, with the addition of such State ('nmniittees as 
are acting as I»cal Committees, number 75, . . , 

It was decided that only those nurses should be eligible for 
enrollment who are graduates of training schools tronnected 
iritb general hospitals of at least fifty beds, unless the appli- 
cant has had subsequent hospital experience or post-graduate 

'War UepArtmeol, General Orders No. 170, D<M!«mber 27, 1911. 



122 HISTORY OF AMERICAN RED CROSS NURSING 

work. Graduates of training Rhoois connected with hospitala 
for Uie insant^ must have had at least six monthfi training in 
a general hospital. . . . 

A special committee wae pro\ided for, to outline a course 
of lectures for enrolled Red Cross Nurses. Mary E. Oladwin, 
superintendent of the City Hospital, Cleveland, Ohio, was 
made chairman of this committee, with the privilege of 
selecting her associates. . . . 

Lectures for Bed Cross Ncrsks 
Object of Lectures 

1. To keep alive the interest which already exists, and to 
bring to the attention of the young graduate the desirability 
and importance of being identified with the Hed Cross Nurs- 
ing Service. 

2. To be a means of education and preparation for future 
work, either in time of peace or war, 

3. To give enrolled nurses more knowledge of the history, 
aims and athievemeuU of the Red Crose, a better under- 
standing of relief problems in general, and of the modem 
hunuinitariau movemeut^j which tK> closely concern nurses. 

4. To furnish a pleasant and useful pretext for bringing 
enrolled nurses together in localities where it is seldom pos- 
sible to provide military or Ke<l Cross speakers. To give to 
nurses in such places a community of interests which shall 
make them more valuable to the Kcd Cross. 

5. To have these papers printed, hut not published until 
after they have been well distributed and use<l. To furnish 
them to Local and State committws. part of whose duties 
it shall be to sec that they are regularly and properly used. 

SCOOESTED OUTUNE 

I. History of Relief and the Red Cross. 

(a) Before the Crimea. 

(b) Florence Nightingale. 
iv) Solferino and ITcnri Dunitat 
(d) Modern Red Cross. 

II, San Francisco Disaster. 

(a) The Disaster. 

(b) Immediate Relief. 

(c) Rehabilitation and Reconstruction. 
III. The Italian Earthquake. 

(a) Tlie DisaHtcr. 

(b) Relief Work — Road Making, Shoemaking, 
etc. 



REORGANIZATION AND AFFILIATION 123 

IV. Chineae Famine. 

(a) Description of Country and Cause of 
Famine. 

(b) Famine Camps — Material Used for Food. 

(c) Newspaper Criticism, i.e.. Futility of Fre- 
quent Relief Unless vSteps Are Taken To- 
wards Prevention. 

V. Spanish-American War. 
VI. Military Hospitals. 
VII. The l^ed Croes in Other Countries. 
VI II. Notable Medical Achievements of U. S. A. 
IX. Forest Fires, Mine Disasters. 
X. Relief Work for Celebrations and Parades.*** 

The f\ill committee on the lecture course were: !Mary E. 
Gladwin, Mabel T. Boardman, Major L^iich, Ernest P. Bick- 
nell and Miss I>elano, ex-otficio. 

Impiirtant details of perfected organization were referred to 

Mias Delano in her report of 1912 : 

At the last meeting of the National Committee, held in 

[[Vaishington. December 4, 1011, it was decided that every 

nir.se enrolled for service under the Red Cross must be a 

leinber of an organization attiliated with the American 

ff\irse8* Association. 

Believing that in order to do effective work, there must be 
coordination of the varioun Red Cross activities, it was sug- 
gpsted by the Xational Committee that there should be ap- 
piintod on the Red Cross relief committee of each institutional 
meml)cr an eurolled Red Cross nurse to represent the nursing 
service. 

In the notes of April, 1912, there comes the anticipation of 
the beautiful building in which the Ked Cross is now housed; 

Mention was made in the November Jourmtl of the proposal 
to erect in the city of Washington a national monument to 
the memory of the brave women of the Civil War. At tlmt 
time no suggestions had been offered as to the fonn which 
this memorial should take, but it seemed a gracious tribute 
to the work of women many of whom had served as nurses 
during the four years of war. It is now proposed that the 
monument to be erected shall take the form of a building 
to he given as headquarters to the American Red Cross in 
perpf*tuity. It seems most appropriate that the humanitarian 
work of the American Red Cross in all the years to come 

*Jounwl Drpiirtnient, October, 1911. 



12* HISTORY OF AMERICAN RED CROSS NURSING 

should be carried on in a building commemoratiDg the zeal 
and devotion of the patriotic women who inaugurated the 
Sanitary Commission, raising railliouK for relief work and 
who braved the dangers and discomforts of fever stricken 
camp or crowded ward to lessen the suffering of the sick and 
woiinded. 

Cnn we wonder that a memorial to them has appealed to 
the public conscieniie and finals favor with all who shared in 
the sorrow and anxiety of those years i' 

In the Bummor of 1D12 the Ninth International Red Cross 
conference was held in Washington, — the first nutsido of 
Europe. The sessions wore held in the Pan-American Build- 
ing. The Secretary of State selected four nurses as official 
delegates. These were: Misses Maxwell, Nevins, Mclsaac and 
Delano. The Red CVoss Nursing Service committees were also 
represented, for there were present Mrs. Gretter of Michigan; 
Miss Giborson of Pennsylvania; Mrs. Tupman of Georgia; 
^liss Robinson of Illinois; Miss Stuff of Nebraska; Miss Rom- 
niell of Minnesota; Misses Black and Fletcher of Virginia; 
Misses Gladwin and Echols of Ohio; Miss Wilkinson of Con- 
necticut and Miss Perry of Nortli Can»Iina, 

At tliat mc?eting the memorial to Misa Nightingale was 
agreed upon of which Miss Delano wrote in her August notes: 

The Red Cross societies of the worhl agreeil to raise a fund 
to be known as the Plorenre Nightingale Foundation. A spe- 
cial committee was appointed to make recommendations con- 
cerning this fund with Sir John Furley ot the St John's 
Ambulance Association as chtiirman. Miss Boardmau and 
MiRs Delano were asked to serve on this <'onmiittec. It was 
agreed that a medal, accompanied by a certificate on vellum, 
to l)e called the Florence Nightingale Medal, should he in- 
stituted and that six sui'h medals, to be increased to the 
number of twelve in the event of a great war, sliould Im? avail- 
able annually: that tliey sliould be granted only to trained 
nurses who may have espci-ially distinguiphed themselves by 
great and exceptional devotion to the sick and wounded in 
peaiv or war. No country may propose more than one can- 
didate for this modal annually. The final award is made by 
the Internatioruil Hcd Cross Committee at ticncva. The 
awarding of these medals to nurses will be akin to the be- 
stowal of the Victoria Cross to British soldiers for "bravery 
in action** and will be the highest honor which can be paid 
to any nurse. A most fitting memorial to one "who rescued 




REORGAMZATION AND AFFILIATION 



125 



I 



from obscurity and gbanio a noble profession/' may this Night- 
ingale Medal prove ever an incentive to higher and higher 
standards of duty among us. 

At that time Miss Delano did not enlarge upon the discussion 
held over the Florence Nightingale Medal, but later (1918) 
^ told something of her part in it, and as it illustrates very 
interestingly her tact in meeting the foreign viewpoint in nurs- 
ing, we include here her subsequent narrative of the difficulty 
of limiting a Nightingale Jtlcdal to a nurse trained ou the 
Nightingale system: 

I was placed on n eonimittee to decide as to the awarding of 
the Nightingale medal for service in time of war; and I 
asjioire you it was no easy task for me to convini'e the other 
membert^ of the committee — (1 believe 1 was the only member 
representing this country, but at any rate I w&^ the only one 
that ftfwke for nurses alone) — first that it should he given 
only for the artual care of the sick and wounded ; and seeond, 
that it !»hould only be awarded to women who could qualify 
as graduate nurses. We were in session for part of two days 
^^fore I convinced them that I wae right that this medal, the 

lorence Nightingale Mediil, should be given to graduate 
nurses for service in the actual care of tlie sick and wounded. 
That eliminated absolutely from any possibility of securing 
this medal women M'ho were engaged in organization work in 
any of the countries of the world. It eliminated any woman 
who might contribute large funds to the organization of the 
nurping service in the time of war. It pinned the award of 
that medal down absolutely to a graduate nurse. At that 
time we could only suggest one and 1 suggested Mary E. 
Gladwin, and I hope that eventually she will receive the 
Florence Nightingale medal.'' 

Misa Delano's eflFort iu thus restricting the medal was heartily 
seconded by Miss BourdniaUf who was fully in accord with her 



At the annual meeting of 1912 Miss IMano, who had l)een 
a member of the War Kclief Pioard since the organization of 
the nursing stTvicc, was a])pointed also a member of the 
National Relief Board. The iirst intimation of an approaehing 
war threat is given in the committtH? reports of that meeting. 
Miw I>elano*a notes contain the following suggestive paragraph: 

' Ptooeodinf^ KatioDAl League (or Kursing EducittioDj 1018, page Idl. 



126 HISTORY OF AMERICAN RED CROSS NIHSING 

At its annual meeting in 1912 the American Medical 
A»4ociatiou nuthorized tlie appointment uf a ooniniittee wliosc 
duty it should be to confer with the American Wed Cross with 
a view to eptablishing a comprehensive system of cooperation 
between the Red Cross and the physicians of the United States. 
This cooperation is expected to be effective in providing 
prompt nnd micquate metlical and surgical attendance on the 
occurrence of preat disasters and also to afford a reserve upon 
which the Red Cross may draw for a medical personnel in 
the event of war. It is probable that a system of enrollment 
will be adopter! which will eventually build up a large force 
of Red Cross physicians representing eyerj' section of the 
country. The committee representing the American Medical 
Asaxiintion in this matter consists of Dr. George M. Kober, 
Washington, D, C, chairman ; Colonel F. A. \Vinter, of the 
Army Medical Corps, and Surgeon E. M. Blackwell of the 
Navy. 

The American Journal of Nursing in February, 1912, made 
this commentary on the situation indicated in the sentences just 
quoted : 

No department made a better showing of work done during 
the year than tbal of nursing service as presented by Miss 
Delano. The medical dopnrtnient of the Ifed Cross is much 
less well organized^ although the American Medical Associa- 
ton has now taken the matter in hand and working through 
a committee will enroll a corps of physicians for Red Cross 
service and to act as an army reserve in time of war. 

In Apri!» 1!)13, there recurs in Miss Delano's notes the in- 
timation of impending war. She wrote: 

A special committee has recently been appointe«3 fof which 
Miss Delano was a member] to formulate plans for the or- 
ganization of a Red Cross personnel to l>e called upon for 
service, either in time of disaster or with the military forces 
in the event of war. ... It is proposed as an experiment to 
organize at various selected points hospital columns made up of 
the following; One director, three assistant directors, who 
shall be phytiifians. six chief nurses and forty-five nurses. 
It is intended that these physicians and nurses shall be brought 
together for special instruction in the duties which would he 
required of them when called upon for service under the Red 
Cross. 

It has been estimated that in the event of war with a first 
class power nearly half a million volunteer troops would be 



REORGAXIZATION AND AFFILIATION 



127 



needed at once and four tbouBand nurses for the Army alone, 
with an additional thousand nurses for the Navy. It is 
imp0P«ibIe to eetimate the future (leinanda but with our ex- 
perienr-ed comniitteeb of nurses and tlie ever increasing en- 
rollment we feel sure there would be no failure on the part 
of the Nursing Service of the Red Cross. 

From this time on there were changes preparatory to war 
serviw. The National Committee on Nursing Service had 
some of these changes. Miss Delano's notes say: 

Owing to his transfer to the Philippines, Major Charles 
Lynch, Medical Corpf*, U. S. A,j hag resigned from this com- 
mittee and in his place Major R. U. Patterson, Medical Corps, 
U. S. A.,, has been appointed. Miss Georgia N^evins, who had 
served on the coramittee since its creation has also resigned 
and Mrs. Lena S. Higbee, superintendent of the Navy Nurse 
Corps, has been appointed by the War Relief Board as her 
fuccesjior. Mips .Tulin C. Stimson nnd Miss Marj* JC. Gladwin 
have also been appointed to fill vacancies on the committee. 
The full committee is as follows: 



Miss Jane A. Delano, Miss 

Chairman. Miss 

Miss Mabel T. Boardman, Mrs. 

Mrs, William K. l)r«per. Miss 

Maj. R. U. Patterson, Miss 

Dr. T. W. Richards, Mrs. 

Dr. Wm. H. Welrh, Miss 

Mrs. Fre<lerick Tice, Miss 



Emma M. Nichols, 
Alma E. Wrigley, 
Whitelaw Reid, 
Anna Maxwell, 
Isabel Mclsaac, 
Lenali Iligbee, 
^larv K. Ciladwin, 
Julia S. Stimson. 



Afl the enrolled Red Cross nurses form the reserve of 
the Army,'* the Surgeon General of the Army has detailed 
a member of the Army Nurse Corps, Miss Anna Reeves, to 
assist in the record work of the Red Cross olTice. This will 
add to the efficiency of the service and give the chairman 
iBiore time for constructive work. 

There has been a satisfactory increase in the number of 
enrollments, and even more discTiminaiion and careful selec- 
tion of nurses on the part of the Local Conmiittees. We now 
have over 4,200 enrolled Red Cross nurses, and have Local 

Though in practice thU had been accepted for a long time the order 
makinjr the Red Cross enrolled nurws the Rewrve Cori»B oi the Army 
VufMiijj; Service waii oniy promu1>;ntp(l in 1910 and read«: "The enrolled 
burft^K of the American Red Cross NurBin); Service will conBtilutc the 
Reverse of the Army Nurse Corpw. and in time of war or othiT I'mergency 
may, with their own convent, be ussicned to active duty in the military 
rflUMithment." Manual for Medical Uepartmeot, U. 8. Army, 1016. 



128 HISTORY OF AMERICAN RED CROSS NURSING 



Committees in practically all of the large nursing centers 
in the Unitecl States. 

The committees appointed primarily for the enrollment of 
nurses have responded with enthusiasm to aU demands made 
upon them. In organizing our rural nursing service, we have 
sought their advice and assistance. In the development of 
our classes of instruction for women we shall rely upon them 
to suggest instructors and examiners from among the Red 
Cross nurses,^" 

Early in 1914 Miss Delano reported: 

Late in April the National Committee on Red Cross Nurs- 
ing Service was instructed by the \Var Kelief Board to com- 
municate with all Lot'al ('ommittecs asking for a list of 
nurses available should it be necessary to call on our Red 
Cross personnel for service in Mexico. The response was so 
prompt and enthusiastic that we felt secure in urging all 
nurses not to begin preparations for service or give up their 
present positions unless delinite instructions were received. 
It seemed wise, however, to have a small group of Red Cross 
Dursefi ready, and a few Local Committees in nearby cities 
were asked to prepare eligible lists. These nurses were then 
requested to present themselves for physical examination, anti- 
typhoid treatment and vaccination for smallpox. 

On May 9, a call came from the Surgeon General of the 
LT^nited States Army for three Red Cross nurses to go to Vera 
Cruz, and the following Washington nurses were selected from 
among those on the available list: Kathrine Donnelly, Lulu 
T. Floyd, Nannie B. Hardy and Alice B. Harvey. These 
nurses reported at once to Ked Cross Headquarters, and in a 
few hours all necessary preparations for their departure had 
been made.. They left Washington on Sunday afternoon, 
May 10, in charge of Miss Elizabeth Reed, a member of the 
Army Nurse Corps, who has been assigueil as chief nurse 
for vera Cruz. 

A circular of information giving definite instructions con- 
cerning uniforms and equipment has been prepared in the 
hope that our nurses may avoid the common mistake of carry- 
ing useless luggage and leaving at home the things most 
needed. A special field uniform of blue-gray had been 
adonted, of such material and style as to launder easily and 
pacK in small space, the cap, collar and apron of which can 
DC laundered without starch ; while most suitable for service 
in a warm country the uniform is still ueat and attractive." 

"Reports, Nntionnl Committise on Nursing Service, Docember, 1913. 
** Amarioan Red Crog§ iiagaeine, July, 1914. 




REORGANIZATION AND AFFILIATION 129 

This note of July, 1914, n^capitnlated what seemed later to 
have been a game of child's play, faintly foreshadowing the 

L terror about to descend on the world. 
In this section of this history no attempt will be made to do 
more than compile in very brief form the share of the Nursing 
Service in those instances where nursing was required to supple- 
ment the general work of relief, 
b The San Francisco fire, following the earthquake, brought 
out nurses as volunteers. Affiliation had not taken place, but 
there was a local Red Cross society, with a committee on 
nursc-s. The chairman of that oommitteej Mrs. L. L. Duubar, 
wrote: 

There was no further need of the Red Cross Society in 
San Francisco until lOOfi. In 1906 when Congress made the 
society national, an organization was effected in San Fran- 
cisco with Judge Morrow as president. There seemed no 
hurry and Judge Morrow was a busy man and no committees 
were appointed until April 17, l!ti>(>, when a meeting was 
called, and Judge Morrow appointed the committees on 
nurses and physicians. Then the very next day came the 
earthquake and fire. I had been appointed chairman of the 
committee on nurses, but I was out of the city at the time 
and could not get back into it for a week. Meanwhile our 
nurses had responded to the need, and though without or- 
ganization had done much. As soon as I was able to get 
back to the city and some organization conld be effected, 
conditions greatly improved.** 

The call to send nurses to the scenes of the Mississippi floods 
(April 1908) has been mentioned as the first such demand that 
was made on the Washington Headquarters after the interest of 
nurses in the Red Cross had led them to join local and state 
Red Cross societies in fairly large numbers. Eighteen nurses 
were sent from New York, Pennsylvania, and District of 
Colombia Brandies of the Red Cross, and emergency hospitals 
WCTe established. The work centered in Hattiesburg, Missis- 
sippi. Half an hour after the wire came to Philadelphia, ask- 
ing for nurses, the nurses were on their way. The character of 
the Bcrvici? rendered is shown in the report of the New York 
Brancii, from which the following brief portion of the narrative 
as told by the nurse in charge is taken: 

*ff««f CroBt Mapowmet Januuy, 1008. 



130 HISTORY OF AAIERICAX RED CROSS NURSING 

, We arriyed in Hattie«burg, May 17. 

Previous to the coming of the Red Cross nursed the local 
relief committees had sent to New Orleans for six Charity 
Hospital graduates and were paying them at the rate of $25 
per week for relief work in the two hospitals. Three of these 
nurses were discharged soon after the arrival of the first 
detachment of Red Cross nurses, and the remaining three 
after our arrival. Three of our nurses were assigned to night 

• doty, two to day duty* and I was to act with Major Simpson 
and Captain Ashford in coordinating the food, medical sup* 
plies and repairs, also clothes, equipment and the names of 
discharged patients who were entitled to transportation, etc. 
. . . My duty was to go each morning to the hospitals, army 
tents and Red Cross relief stations; and collect and inspect 
all requisitions, when needful make suggestions and eliminate 
all requisitions not provided in the list of medical and com- 
missary supplies provided by the Relief Expedition. These 
requisitions were then taken by me to the official offices to 
be approved and signed, then to the storehoxise to be filled 
and delivered. All complaints from either superintendenta, 
patients or head nurses regarding supplies, etc, were furnished 
me in written signed complaints, to be adjusted by the offi- 
cials in whose department they were. As the buildings were 
from one-quarter to one-half mile apart and as I went mostly 
on foot, my first week was a pretty busy one, until I had 
learned to systematize my work. 

May 29, 1908. (signed) Genovieva Pkttit." 

The Dallas floods occurring in the summer of 1008 created 
conditions that called for nurses. The service was supplied 
entirely by the Texas Red Cross State Nursing Committee, Its 
preai<lent, Mary Shennan Allen, wrote of the experience that 
she and her staff had there: 



As many people in the larger camps were sick, from ex- 
posure and the terrible experience they had passed through^ 
some being days in tree-tops before resfued, it was thou^t 
advisable to establish emergency hospitals in Oamp Hay and 
Camp Ferris. We, therefore, issued a call for nurses and 
nearly all of our enrolled nurses responded to the call, and 

"The American NntionnI Red Cross Society, at its meeting lield 1»«t 
Koveint>er, dcrorntrd Kli/4ibi>th M. Hewitt and J. Beatrice Itowman. both 
o( tho Nurse Corps, Unitei! States Navy, with « service har for volunteer 
work done under the Red Crosa at Hattiesburg. Miaa.. after the cyclone 
of la^t iprinff. The bar is of bronze and on itd face are the worda, 
Hatticaburg, 1908." American Journci of Nursing, September, 1908. 




KEORGAMZATIOX AND AFFILIATION 



131 



I 
I 



immediately wo edtabiifJied n Inrpe field eniergency hospital, 
fully equipped with drugs, eauitary drefisinge, cots for the 
sick and all appliaueeti to care for those that needed the at- 
tention of the Red Cross. Dot-tons Sloval, Furgesou, Blauk 
ani3 Davis had diarge of the medical department; Miss Mary 
Ennisson, charge of the honpital work, and the ilisscB Annie 
Swingky and Ailrian Palm, trained Ked Cross nurses, charge 
of nurses' department. Our Emergency Hospital stood at the 
head of a hroad avenue of tents. The camp presented a beauti- 
ful picture and the United States flags and Red Cross flags 
floating at>ove our hospital tents could be seen for miles 
Around. Sanitary conditions and perfect order were main- 
tftiue<l during the entire time. Our doctors and nurses were 
kept buf^y caring for cases of fever and other diseases caused 
by exposure. 

Our doctors and nurses cared for many cases of destitution 
and sickness in both camps, as well as in all parts of the city 
where needed, and it has been the universal expression that 
the prompt, et!icient and systematized work of the Red Cross 
did much lu preventing an epidemic of fever.^* 

Xo tiiirsca were sent from America by our Red Cross at the 
time of the earthquake in Sicily (1908), but three or four 
American nurses were in Italy at tliat time and volnnteered 
ihcir sen'ices. It is interesting to know that one of these was 
AiioG Fitzgerald, a Johns Hopkins nurse, whose later important 
potsition as chief nurse of the eommission to France and still 
ltt<*r as diret^tor of the nursing Service of the League of ^ed 
Cmes Societies, will be fully told in anoth(T chapter. 

When a building collapsed in Philadelphia, July, lOOO, a 
tingle Hcd CVoss nurse, ilargaret B. Simon, was the heroine of 
tliia accident, and for her work she was commended by personal 
letters from the Mayor of Philadelphia, and from the (then) 
Pre«ident Taft, 

At the time of the Cherry Mine disaster, nurses, though 
ready, were not sent by the Washington i>fHce, as the Visiting 
Nnrses' Asaociation of Chicago had enough of its staff to fill 
the required service. 

During the Mexican l)order disturbances in IDll, the Cen- 
tral Office of the Nursing Service at Washingt4>n responded 
;tfly, twice, to calls for nursing aid, once for Douglas, 
la, and nejct from El Paso, Texas. In tLe former case the 
expected net^essity did not arise, and in the latter, two Ameri- 

".iMrn'oan Journal of Xursing, October, 1008. 



132 HISTORY OF AMERICAN RED CROSS NURSING 

can Red Cross nurses bogiin to orgnnize work, whidi was then 
taken over by the Mexican Red Cross. 

When the Austin Dam broke in 1911, the Red Cross Service 
stood ready to provide nurses, but they were not needed, as the 
State of Pennsylvania provided physicians and nurses. 

In the floods of early suiumer, 11)12, Mississippi and Louis- 
iana being the chief sufferers, the Red Cross Nursing Service 
organized relief for the sickness which resulted from the floods 
and the hot weather. A staff of nurses was mustered by the 
Kansas City Local Committee on Red Cross Nursing Service at 
the request of the Washington office, to be sent to Mississippi, 
leaving New Orleans nurses to supply I^uisiana. Camps were 
formed for the refugees and the nurses were stationed in these. 
Thirteen nurses were assiguetl to duty. Miss Delano wrote:*' 

In each case the response to our call was prompt. Too 
mmli launot be said in praise of the splendid spirit shown 
by tbe nurses. 

The Omalia cyclone occurred in March, 1913. In the 
American Bed Croas Magazine for July, 1913, Miss Delano 
wrote: 

Soon after the April number of the Hed Cross Magimn$ 
went into print we were called upou to faro a series of dia- 
a»t«ra such as this country had never before experienced. The 
elliciency and preparednesB of the iVureing Service of the Red 
Cross were well testeil and the nurses were found ready to 
meet all the demands made upon them. 

As soon as the news of tlie Onmlia disaster was received 
in Washington communication was established, through the 
courtesy of tlie t'nited FrnsH, with Miss Tiillian B. Stuff, Act- 
ing Chairman of the Nebraska Committee on Red Cross 
Nursing Service, and authority was given lier to call out Red 
Cross nurses and to organize such relief as lay in her power. 
An emergency hospital of one hundred and fifty beds was 
establishc*! in a local gymnasium where they cared for the 
injured and homeless. 

Miss Stuff, in her ref>ort., says, "We did not wait for calls 
to come to us, but made a house to house canvans as nuiny 
were huddled together among neighbors without proper cloth- 
ing in which to appear to ask for aid. Nor did wejainfine 
our efforts entirely to nursing, but gave whatever help was 
needed." 

""AmcriooA JourwU of NurMtnff, September, 1912. 



REORGANIZATION AND AFFILIATION 133 

A hospital of one hundred fifty beds was established and 
eight Red Cross nurses were continued in service there for 
some weeks after the disaster. 

Two days after the Omnha cyclone, vague nimors came to 
us over press wires of the Dayton horror. Telegram after 
telegram was sent to our Local Committees on Nursing 
Service and on March 26 a message came through from Cin- 
cinnati concerning the assignment of their own nurses to 
duty and asking that one hundred additional nurses be sent 
to them at once from adjoining cities. 

The chairman of the National Committee on Red Cross 
Nursing Servire and ten Red Cross nurses left Washington 
irith Mi80 Boardman on Friday^ March 28, at midnight on 
a special relief train sent out by the Washin^on Host. This 
train reached Cincinnati Sunday morning and found the 
mopt perfef.'t coojieration between the Local Chapter, nursing 
committees and various relief agencies."^ 

In her Annual Report^ Miss Delano said: 

During the first forty-eight hours following the Ohio 
flood, which occurred March 25, seventy-seven nurses were 
afisigned to duty by the Cinciimati Local Committee, and in 
Tesponse to telegrams sent from Wasluugtou one hundred 
and thirty-six nurses from other cities reached the flooded 
area during the next forty-eigiit hours. These nurses were 
•ent from Chicago, St. Ix)ui8, Detroit, Ann Arbor, Cleveland, 
and Akron, while ten went from Washington and Baltimore 
on the *'Po8t Special" with llip cliairnian of the National 
Committee. Red Cross nurses were assigned to the following 
cities in the fiooded area: 

Columbus, Dayton. Ilamiltou^ Middleton, West Carrolton, 
Portsmouth, Miamisburg, Olcndale, Peru, Shawnectown, 
Catletfiburg, Maysville, Point Pleasant. 

The number of nurses assigned to duty at any one place 
and the length of service depended ujion loi.*al itinditions. 

We were fortunate in having an active Ited Cross Chapter in 
Cincinnati cooperating with the Local Coniniittcc on iVursing 
Service, and through the prompt action of Miss Annie Laws, 
secretary of the Chapter, Miss (Greenwood, chairman of the 
nareing committee, and Miss Reinecke, Rei] CroKs nurse in 
cbarge of headquarters, nurses were sent to the stricken com- 
mnnities before organized relief could be undertaken. De- 
tailed reports of the work done by our nurses under the 
auperrision of Miss Mary E. Gladwin, chairman of the Ohio 

BM Crom Maffamine^ July, 1013. 



134 mSTORY OF AMERICAN RED CROSS NURSING 

State Committee^ and in charge of the nursing relief in 
Dayton; Miss Ella Phillips Crandall, of Teaeherg College, 
New York, responsihle for about tifty inirseg doing sanitary 
inepec-tiou work under the direetion of Major T. L. Rhoade, 
Medical Corps, I'nited States Army; Mies Mary C. Wheeler, 
superintendent of Illinois Training School for Nurses, Chi- 
cago; Miss Emily McLaughlin, superintendent, Harper Hos- 
pital, Detroit; Miss Julia C. Stimson, in charge of social 
service work in St. Louie, Mo., Mies Jennie L. Tuttle, superin- 
tendent, Visiting Nurse Association, Columbus; Miss Mary B, 
Wilson, and Miss Ahbie Roberts, of Cincinnati, have already 
appeared in the Hed Cross Magazine. These nurses and 
many others were relieved from responsible positions, and in 
some instances subetilutes were employed in order that 
they might meet their obligations as enrolled Red Cross 
nurses. 

In describing the work of the Red Cross nurses in Dayton, Miss 
Gladwin wrote : 

They may be found serenely picking their way aronnd 
wrecked furniture, Bt>ddtni mHttrcsses, ruins of porches and 
sheds; wearing rubber boots, with skirts kilted high, wet 
nearly to the uaist; sending sick people to the hospitals, in- 
specting plumbing, back yards and cellars; superintending all 
sorts of work from feeding the baby to the digging of trenches. 
Through all parts of the flooded city nurses go on similar 
errands, inspecting nearly nine thousand homes and reporting 
conditions found. 

Through the activity of Mrs. H. C. Lounsbury, chairman 
of the West Virginia State Committee on Red Cross Nursing 
Service, most efficient relief was rendered at Point Pleasant, 
West Virginia. Mrs. Lounsbury and two other Red Cmss 
nurses ^'wcnt down the river on a boat loaded with supplies 
furnished by the citizens of Charleston and the neighboring 
towns.'' They found little sickness at Point Pleasant, and 
devoted their efTorta cJiicfly to the distribution of clothing 
and supplies and the establishing and maintaining of sanitary 
conditions." 

The nurses were on duty for four weeks, and it is recorded 
that in Dayton alone they cared for over two thousand cases of 
illness or aceideut. This was the severest test yet given to the 
Red Cross Nursing Service, and the way in which it was met 



Report of the National L'oinmitlee on Red CruHS Nursing Strvk-e, 1913 




REORGANIZATION AND AFFILIATION 



idj 



I 



vaa justiiiabl^' regarded as a triumphant proof that organiza- 
tion was now in perfect running order.'' 

When a terriblv destructive fire in Salem made thousands 
of people homeleafl the Boston Local Committee on Red Cross 
Nursing Service took charge of nursing relief. Stations were 
appointed and Red Cross nurses assigned to cacli. A Slater- 
nitjr Hospital with a Milk and Baby Hygiene Station was 
organized and a Contagious Hospital established. The work 
of the nurses was largely preventive and was well and thor- 
oughly done. 

The Easilarid disaster which occurred in 1915, was reported 
ffl follows : 

On July 24 one of the large excursion steamers, which had 
been chartered by the employees of the Western Electric Com- 
pany, overturned just before the boat was ready to leave the 
dock. There were alioiit twentj'-five hundred people on board 
and of this number over nine hundre*] lost their lives. The 
accident occurred alx)ut seven o'clock in the morning. The 
chairman of the Local Committee on Bed Cross Nursing 
Service, Miss Minnie Ahrens, heard of the catastrophe on 
the way to her office and started at once with another nurse 
for the scene of disaster. She telephoned immediately for 
additional nurses, not only to headquarters of the enrolled 
Red Cross nurses, but to the regititrar of the Central Di- 
rectory and all Public Health Xur^ing organizations. Nurses 
rpsi>onded quickly and reported on arrival to the chairman 
of the Committee for instructions. By one o'clock at least 
one hundred nurses were on duty. They worked in the pour- 
ing rain wherever the rescued were carried, and many taken 
from the water before nine o'clock were resuscitated. About 
noon shelter was provided in the Reed Murdock Wholesale 
Grocery Building, and artificial respiration, hot applications 
and otner emergency treatments were continued as long as 
there was the HJi^htest Iiope. When nothintj more could be 
done for the injured, a morgue was established at the Second 
Regiment Armorj' where relatives could identify their dead. 
Five Red Cross nurses were assigned to duty in an emergency 
hospital at the morgue to give such care and comfort as might 
be possible to those wlio were bereaved. This emergency hos- 
pital was continued with relays of Red Cross nurses until 

*Sae kIho articles on the Dayton DiHuster in the Americ^in Journal of 
iSmnimg. 1813. The Re«I Cross in Dnyton, by Mary E. Gladwin. The 
Work of the Cincinnati Local Red Crosa Nursing Servii-e C-ommittee, by 
Umtj IL Qrerawood. Report sent to Mim Delano by £lla Phillips Cran- 
teJl, etc. 



136 HISTORY OF AMERICAN RED CROSS NURSING 



Wednesday, July 28, all serving gratuitously. In closing her 
report Miss Ahrcns, who had charge of the work and who 
rendered moyt elllcient service, said: "It is at Buch a time 
that we realize and appreciate the value of our Red Cross 
Nursing Service. Witiiout organization it would have been 
impossible to have had such cooperation.** 

The year 1917 had n niiTnber of calls for nurses in times of 
disaster; six were called to New Castle in Indiana; nineteen to 
New Albany, Indiana; four to Chester, Pennsylvania; eight to 
Atlanta, Georgia; thirty-four to two Illinois towns; five to 
Hickman, Kentucky; three to a Miasouri town; one to Spring- 
port, Michigan; five to East St Louis; one to Clay, Kentucky. 
The crowning disaster of 1917 was the explosion at Halifax, 
Nova Scotia. 

The terrible calamity resulting from the explosion of war 
munitions in the harbor of Halifax, on the 0th of December, 
1917, will long be reineiubered. Amidst the many forms of 
relief and succor called for by the unparalleled destructiveness 
of the disaster, nursing aid was needed. From this country a 
number of nurses were recruited in desperate haste by Red 
Cress committees and hospital uuthoritieB of the New England 
Btatee, as being the nearest to the scene. 

The Providence Local Committee on Red Cross Nursing 
Service sent fifty nurses in charge of Grace L. Mclntyre, Chief 
Nurse; various hospitals sent physicians and nurses; the Com- 
mittee of National Defense and the Public Safety Committee 
formed units of physicians who chose their own nurses, and 
thus the New England Division Headquarters of the Red Cross 
was not called upon to supply nurses. 

Miss Delano was kept informed of the movements of nurses 
and on December 17 wrote to Elizabeth F, Sherman, of Provi- 
dence, who had been prominent in collecting Miss Mclntyre's 
staff: 

December 17, 1917. 
May I thank you for your very satisfactory report of the 
Halifax BctiNTties. It is our denire that Red Cross Com- 
mittees lihatl cooperate in every way possible in relief work 
of this kind without waiting for orders from Headquarters, 
aa the important thing iu disaster relief is to meet the need 

"Annual Report of the Committee on Red CroM Nursing Serviee. 1016. 
See rIm) tlip R(h1 Cfftflfl. by Minnie Ahrene, American Journal of Nwrmng, 

October. 1915. 




REORGANIZATION AND AFFILIATION 



137 



ft8 quickly as possible. I am more than glad that you vere 
able to secure the nurses, and appreciate greatly your untiring 
efforts iu the matter. 

In this brief sununary of special emergency nursing episodes 
there has been no attempt made to cover purely local, isolated 
instances where Red Cross nurses have come forward. Nor can 
the numerous list be included of such preparations for nursing 
care as were made, for instance, at the time of the Veterans' 
Reunion at Gettysburg, and similar reunions ; still less the long 
list of such occasions as might be covered by the term "Dress 
Parade." For events of this kind the report of a typical year 
will give sufficient idea, as follows: 



AxjnjAJL Bjepobt, 1917. 

Relief Actwitiet. 

Tlw following relief activities have been conducted during the paat year 
by our Local Committees: 



Datfi 


Town or City 


Occasion of Service 


Red Cross Nurses 
on Duty 


JaaoftTj 1 


Pasadena, Calif. 


Tournament of Roses 


2 




March 4 


Wasbington, D. C. 


Inauguration 


19 




UardL6-10 


Cleveland, Ohio 


Central Armory 

Celebration 


10 




« 12 


New Castle, Ind. 


Cyclone Disaster 


6 










10 from Indiana 


- 23 


New Albany 


Tornado Disaster 


5 
4 


" Cincinnati 
" Kentucky 


April 10 


Chester, Penna. 


Gddystone Disaster 


4 




- 16 to 


Washington, D. C. 


Encampment, Navy 






Hay 26 




League 


9 




May 21 


AtlanU, Qa. 


Fire Disaster 


8 
8 


" Bloomington, 
111. 


- 25 


Charleston, 111. 


Cyclone Disaster 


4 


" Jacksonville 




Hattoon, 111. 


Cyclone Disaster 


6 

15 

I 


" Peoria, 111. 
" Chicago, in. 
" Ft. Wayne, 
Ind. 


- 29 


Hickman, Kentucky 


Cyclone Disaster 


6 




« 10 


BnxAlyn, N. Y. 


Unveiling Lafayette 
Statue by General 
Joffre 


4 





138 HISTORY OF AMERICAN RED CROSS NURSING 



Date 


Town or City 


Occasion of Service 


Red Cross Nuraea 
OB Duty 


May 30 


Bridgeport, Comt. 


Memorial Day TSxer- 
cisea 


8 




« 31 to 


Mineral Point, Mo. 


Tornado Disaster 


3 




June 30 










June 2-9 


Washington, D. C. 


Confederate Reunicm 


20 




« 9 


Springport, Mich. 


Tornado Disaster 


1 




" 17-22 


Atlanta, Ga. 


Rotary Convention 


4 




" 3-6 


East St. Louis, III. 


Race Riots 


5 




July 4 


Phelps. N. Y. 


Military Maneuvers 


3 




" 4 


Newport, R. L 


Parade 


1 




" 28 to 


Bridgeport, Conn. 


"Lordship Park" 


1 




Sept. 3 










August 4 


Clay, Kentucky 


Mine Disaster 


1 






Albany, N. Y. 


State Federation of 
Women's Clubs 


9 


■ 


Septem- 


Grand Rapids, Mich. 


Union Depot for 


2 




ber 10 




troops passing 
through 







CHAPTER IV 



THE MEEOY BIHP 



The 8. S, ''Red Cross" Sail&— Paignton, England— Pan, 
France — Kief, Russia — (Jleiwiiz, Germany — Koael, Ger- 
many — Vienna, A uatria^ Budapest, Hungary — Belgrade, 
Serbia — Gevgeli, Serbia — Vvetot, France — La Panne, Bel- 
gium — American. National Red Cross Ileadqitarters — Close 
of the Early Foreign Relief Program. 



» 



I 



A WHITE ship banded witli scarlet, with a Red Cross 
flaming on her funnels, weighed anchor in the sunlit 
waters of the Hudson River and with the bells and 
vbistlea of ferries and tug^boats, the salute of liners and the 
throaty roar of men-o*-war to voice the God-speed of a nation, 
stouned out to the gray Atlantic, bound on a rare mission to 
ing Europe. The day was September 12, 1S)14. 
AgBinst the lower rail of this good ship, the Red Cross, was 
mked a line of women, who watched Manhattan fade away 
and knew not what horror of war might l)e theirs before they 
Hw that broken sky-line again. The white caps, tlie gray uni- 
forms, the line of scarlet as the fresh sea wind blew back the 
active Bervice capes, proclaimed their identity. The Red Cross 
Xnrsixig Service, conceived in the suffering of the Civil and 
Spaniab- American wars, brought into being by the affiliation of 
toe American Nurses* Association and the American Red Cross, 
trartnred and developed through five years of intensive organi- 
zation by Miss Delano and the National Committee, faced the 
tDO0t formidable test of its hitherto dormant powers. With its 
present resources \intried, its potential strength ungucased, it 
wu shouldering its first burden of neutral humanitarian ser- 
Tice to the Allied and Central Powers. 

At e joint meeting of the Tnteniational and War Relief 
Boanb held on August 5, 11)14, the American Red Cross voted 
to cfaarter a ship to carry trained personnel and hospital 

139 



140 HISTORY OF AMERICAN RED CROSS NITRSING 

supplies to the countries involved in the European War. The 
story of the immediate consequences of this action was told by 
Miss Boardman in the Red Cross Magazine of October, 1914: 

A committee consisj^iug of Mr. Bernard N". Baker, of 
Baltimore; Surgeon General William C. Gorgas, U. S. A.; 
Surgeon General William C. Braisteii, U. 8. N. ; &nd Chief 
Constructor Hichard M. Watt» U. S. N., was ap|>ointed to 
secure a suitable ship. No American vessel was available, 
but two ships were most generously offered free of charge by 
the Hamburg-American Line and by the Austro-American 
Line. The committee inspected both ships and finally selected 
tlie Hamburg, of the former company, as beet suited to the 
purpose. 

By special Act of Congress [then in session], the ship flies 
the American and Hed Cross HagH, had a temporary American 
registry nnd has changed her name to that of the Red Cross, 
sailing from New York. According to the colors designated 
for such a ship by the treaty of The Hague, she was painted 
white with a broad red band. 

Major Robert U. Patterson, Medical Corps, U. S. A., Chief 
of the Red Cross Medical Bureau, soon secured his corps of 
surgetms. Miss Delano, chairman of the National Committee 
on Red Cross Nursing Service, through the cooperation of 
her Local Committees, selected from among volunteers from 
our five thousand Red Cross trained nurses, those beet fitted 
for this special service. [Miss Helen Scott Hay was general 
superintendent of nurses of the Red Cross Ship.] 

Admiral Aaron Ward, U. S. N.. retired, who was in Europe, 
accepted by cable the request that he take charee of the 
expedition, joining the ship in England. Admiral Blue, of 
the Navy, lent his aid to secure the rest of the officers. Cap- 
tain Armigtead Rust took command of the ship and with him 
are associated other retired officers, Commander E. H. De- 
lany. U. S. N., as chief engineer; Commander J. S. Dodd- 
ridge, U. S. N., and Lieutenant Gilford Darst, U. S. N.; Mr. 
Richard D. L. Mohun is the paymaster. Captain Jarka, 
superintendent of this line, gave invaluable service in the 
coaling and provisioning of the ship. The painters hung 
along her sides and busily plied their brushes the moment 
the coaling was over. 

The S. S. Eed Cross was loaded from warehouses in Brook- 
lyn, tlio uso of which were donated by Mr. Irving Bush. Colo- 
nel S. L. I>. Slocura, U. S. A., retired, was in command of the 
loading of hospital and other supplies. Four hundred thou- 




THE MERCY SHIP 



141 



I cocc 



I 



* 



potuids of cotton, two huudred and iifty thousand meters 
Mf gauxe, &ftecD thousand pounds of bandages, thirty gallouB 
of iodine^ two thouflund cans of ether, rubl)er j^loves, vaseline, 
oicoa, tobacH-o and othrr comforts and necesBilies for the care 
of the sick, tilled the hold of the liner. Beeaiise of this cargo 
becaose of her passengers, the Red (Jroan rweived the name 

the "Mercy Ship" from the friendly pri'sa. 

The profc*asional persfuinel of this relief expedition was 
made up of ten units, each c<ju»posod of twelve nurses and three 
euTgeoiiB. Units A and B were assigned to Pau, France ; D and 
F to Paignton, England ; O and H to Kief, Russia ; G and I to 
Ocnnany: K to Austria and E to Budapest, Hungary. A 
Serbian unit, of which Dr. Edward W. Ryan was director and 
Harf E. Gladwin, chief nurse, had proceeded Hve days before 
tbr sailijig of the Mercy Ship on the merchant liner loannina 
bound for the ilediterranean and Nish. 

The auperintendent of nurses of the S. S. Red Cross was 
nelen Scott Hay. The assignment to the Mercy Ship which 
brings her for the first time into this history was in keeping 
with her subsequently romantic and brilliant career in Red 
Croas service. She was p*aduat<^ from Northwestern Academy 
in 1889 and received her B,L. degree from Northwestern 
UnirerBity four years later. Further theoretical phases of her 
broad education were completed in 1900 at the University of 
Chicago. She had entered the Illinois Training School for 
Nurses in 1893 and following her j^aduation liecame asaociated 
in executive capacities of varying types with the Southwestern 
Iowa Hospital for the Insane at Clarinda, Iowa, and with 
private sanatoria in Los Angeles, California. She was super- 
iDtenilent of nurses at the County Institute for the Insane and 
Indigent at Chicago and later superintendent of the hospital 
tod training school of the Pasadena Hospital, Pasadena, Cali- 
fornia. Private duty nursing claimed her attention at inter- 
mittent periods. An interesting break in her professional career 
ia marked by a year as priuoipal of the Savannah High School, 
her native village in Illinois. She became superintendent of 
ourflos of her ahna mater, the Illinois Training School, in l'.>0(» 
Ufl remained there until 1012. After eighti-en months spent in 
tnrel, she undertc>ok the organization of tiie West Suburban 
Hospital and School for Nurses at Oak Park, Illinois, and re- 
nuined there six months, resigning to accept her first lU^d Cross 
warm. 



142 HISTORY OF AMERICAN RED CROSS NlfRSING 

Miaa Hay's early war service was closely interwoven with a 
project of uursiiig education which first linked, the i\iiierican 
lied Cross with the developuient of foreign nursing. Before 
the declaration of war, (jueeu Eleanora of Bulgaria had ap- 
pealed to National Headquarters for advice and assistance in 
establishing a training school for uui'ses in Sofia in accordance 
with American standards. In the Red Cross Annual Report 
for 1914, Miss Delano stated this prospective plan of the 
kcen-visioned Queen : 

She wished to secure an American superintendent to or- 
ganize a training school and to send to America four Bul- 
garian young women of t'ducation and promise who could 
fulfill the requirement*! for admission to one of our best 
Bchoola for nurses. Thet-e pupils were to enter the Presby- 
terian Hospital School for Nurses in New York City. Miss 
Helen Scott Hay was selected by the Red Cross to establish 
the school in Bulgaria. The Red Cross agsuuied the re- 
sponsibility for her salary for three years and she was to have 
Hailed for Bulgaria [August 4, IIU \]. The diHlaration of war 
made it necessary to abandon our plans temporarily, ren- 
dering it possible, however, for us to assign Miss Hay to 
duty on the Red Cross Ship. 

In organizing the nursing staffs of the ten units, iliss Delano 
and Miss Hay were guided in their assignments by the princi- 
ple that graduates from the same school and section of the 
couutrv would work advantageously together. An earnest spirit 
characterized these surgeons and nurses bound on their <'ni- 
Bador's mission during that memorable Septejul)er of 1014. la 
a leading editorial the American Journal of Nursinrj voiced the 
sentiment of the Red Cross: *'()ur inirses have been sent not to 
lead others or to show how Kcd (^mss work should 1)0 dtmc, hut 
to supplement the existing relief work, to piece in where there 
is no one else to serve." 

Individualism also gave way before the Red Cross ideal of 
neutrality. Although all the uursi's were native-born citizens 
of the United States^ many of their namc»s were distinctly con- 
tinental. After a tirst momeut of astonishment, they agreed to 
follow the European custom and to be known only as ''Sister 
Donna" or "Sister Charlotte," titles appropriate indeed when 
it is rcmeuihered thut the old Sanskrit word for **sister' meant 
"comforter," 

The one hundred and twenty-six nurst^ sailing on the Mercy 




THE MERCY SHIP 



U3 



I 



Ship had boon assembled through the Local Committees of 
Manhuttaii, B<istou, Brooklyn, Philadelpliia, Baltimore, Xew 
Hampshirt*, New Jersey, Kochester, Buffalo, Detroit, Albany, 
Chicago. Kansas City, Cincinnati, Akron, Clevchind, Cohira- 
bu*, C'ouuecficnt and Washington, D. C\ A diary written dur- 
ing the quiet days at sea, presented a vivid picture of this 
nrift ZDobiliKatiou : 

On hoard the S. S. Bed Cross, 
September 23, 1914. 

Almost a month has passed since a telegram came from 
Miss Delano saying, "Report Wednesday in New York for 
Rwl Cross service iu Europe." As I read over that telegram, 
a queer feeling come into my thront. Then with pciicil and 
pad I was soon busy making out lists of necetjeary articles. 
Hurried shopping followed in the morning. Constant tele- 
phone calls from friends brought varied questions: "Why 
■re you going?" "It wont be any fun !" "How I envy you the 
opjwrtunily !'* "Please send me postcards every wnek, won't 
you?'* "I have a cousic in Germany — give her my love." "Wc 
have just finished a bushel basket of oandages for the Allies 
we want you to take over." 

To imve only forty-eight hours in which to adjust your 
afTaira and to get your mind into a realization that all things 
of your former life are to cease and an entirely new and 
very real existence is to begin is no easy task. I can still 
h*'ar my mother's "Yes, you should go/' though the look in 
her eyes belied her words. My brother's "Be a good soldier, 
«is!" is all mixed up with "duffel bags" and "war zones" and 
the prescribed number of flannel night-gowns to be taken. 

On Wednesday evening, September 2, nurses began to arrive 
in New York from all parts of the country. In view of the 
fact that many nurses wore on their vacations, their mobiliza- 
lioc within two days after their **travel orders'' wore received, 
wift Trmarkably swift. They were entertained at the Central 
CInb for Xurses, 54 East 34th Street. This was conveniently 
near the New York County (Chapter, where they were equipped 
with the regulation uniform upc:tn their arrival. Gray uni- 
fonnit, white aprons, caps with a small lied Cross in front, soft 
oollans, a navv blue cape lined with scarlet and with the Red 
Cmw on the left side, a dark blue felt hat, a water-proof duffel 
Uig of brown canvas closed with a bar and lock and conspicu- 
ouily zruirked with a Ked Cross encircled by the words, "Ameri- 
can Red Crose/' were given each nurse. The duflFel bags, con- 



)t a. J 



lU HISTORY OF AMERICAN RED CROSS NURSING 

tBining three additional bugs, oue for shoes, one for lanndry an^jl 
one i^ontaining scissors, uctidlcfi, emotion, butt-ous and a piece of 
the uniform material, were the only luggage allowed, except &. 
suit case or hand bag. Gray sweaters wore also fnmishi 
Warm storm coats were later added to this equipment. 
-)live green blanket, with a Red Cross woven in the center wj 
presented to each member of the expedition, to be used as a 
steamer robe or extra bed covering in the hard and unusual 
places of war where they soon might find themselves. 

The pli*asant hours on board the Mercy Ship was busily 
taken up with classes. The daily routine resembled more closely 
that of a training sc^hool than an ocean voyage. The nurses 
breakfasted at eight o'clock and spent the morning at lectures 
given by the surgeons on such subjects as First Aid, languages, 
contagious and infectious diseases, anatomy, anaesthetics, ban- 
daging, the metric system, field surgery and allied subjects. At 
eleven-thirty, tliey exercised lu the g,ymuasiiinL After luncheon 
they practised nursing te<»hnique for an hour and a half. At 
four o'clock, tliey attended classes in French and German. 
They dined at seven. Prayers were conducted by Sister Helen 
Scott Hay at eight-thirty and the nurses retired at ten o'clock. 

The grim realities of war hovered near the staunch S. S. Bed 
Cros.'i us she plowed her way through the heav;v' seas. Letters 
and diaries of the nurses recounted the eventful days in the 
war 20DG : i 



Monday, September 14. About 3 A. M. the searehlightB 
of the British truiser, Exscj", found us. After our flags were 
run up and our illuminated Red Crois8 had flashed bank our 
identity, we were allowed to proceed. As this is my first ocean 
trip, my hapiuness will not be complete until there are "shots 
arrows the bow" and I see a whale. 

They found three utowawayu, two of the old crew; sighted 
four ships, ordinary trading vessels. 

Tuesday, September 15, Another lesson on bandaging at 
9:30, Paf^sed south of the banks of Newfoundland at noon. 
Tlie sea is still rough, the sun warm, a strong wind blowin. 
Huge waves come breaking over the decks. We are taki 
the eastern course direct. 

Wednesday, Septeml>er 16. A beautiful, warm, bright 
morning. They founil two more stowaways who looked as if 
they had been making their home in the coal boxes. Had a 
very interesting talk on solutions, preparations for aspirat- 
ing, venous section and lumbar puncture. It is dark ani 




THE MERCY SfflP 



145 



l^and looks very much like rain. The Lusiiania seiit 
a wireless at 8 P. M. saying we were coming to a storm. 
Everything is being tied fast and tacked down. 

Friday, September 18. Such wonderful weather and the 
sick chirping up. Our clasa this morning was on the care 
of the wounded in the field. Then in the afternoon we were 
fihowu the engine room. I thouglit my time had surely come; 
we went down, down, down. It was the cleanest but also the 
oiliest plui-e that I had ever seen. There i-s one fact which 
penetrated my brain and remained there: the stokers are not 
UiG miserably unhappy mortals one is likely to imagine. The 
one 1 Kaw waa blissfully smoking a pipe and singing. Then 
after i had smiled sweetly (and no doubt patronizingly), 
great was his joy when 1 put my hand on a rod covered with 
tar. He laughed outright and so did I. 

Monday, September 21. Major Patterson received a wire- 
less this morning from Dr. Ryan of the Serbian unit, stating 
they have bad bad storms for five days. I veally think we 
are all feeling the depression of this awful fog. It is just 
the feeling that one would have after being put in a cold 

tek and then forgotten by the nurse. 

Tuesday, September 'Z2. Another heart-to-heart talk with 
our superintendent has brought home to us that neither the 
best bandage nor the deft handling of a wound will win for 
lis a place among those we hope to assist; the keen ajid 
ready sympathy nrnt we show them will make or mar our 
mission. 

\V'e<lnesday, September 23. Bishops Headlight has just 
blinked a welcome. Land .at last ! One war vessel at anchor 
in the harbor sent tlie following message by wireless : "God 
bless you and good night.** 

With her flags unfurled to the brilliant glare of aearchlighta 
frum land and from battle craft in thu harbor, the S. S. Red 
Cross lowered anchor ou the evening of September 23 in the 
Bay of Falmouthj England. Surgeons and nurses of four units 
were to leave her at this port, D and F to report to the American 
Ainbaasador iu London for assignment to service wMth the 
Britiah ; C and H to proceed north by way of Scotland and 
Bveden for Petrr^gmd, Russia. The remaining six units des- 
thted for service iu France, Germany and Austria were to 
remain aboard for debarkation at other porta. 

Among the low hills of southeast Englnud lay Paignton, 
Ifoe on October 1, 1014, Unit F reported for duty at "Oldway 
Houae,** then a war hospital for Tommy Atkius. 



U6 HISTORY OF AMERICAN RED CROSS NURSIXG 

'*01dway House" was formt^rly the country estate of Paria 
Singer, of New York, and had been loaned by him for hospital 
purposes to the Committee of the Amcrieau Women's War Re-- 
lief Fnnd. This group of American women, then resident in 
England, included among others, Lady Arthur Paget, Lady 
Henry, the Duchess of ^larllxirou^h, Lady Randolph Chnreh- 
ill, Mrs. Wliitehiw Reid, Mrs. »lohu Astor and Viseouutess 
Har«)urt. Sir William Oslt^r, Baronet, served as consulting 
pliysieian and LienU^uant Colonel K. C. Gunning, Royal Army 
Medical Corps, as military commandant. To this l>eautiful 
place with its spacious porks faring the Ohiinnel, its broad 
terraces and columnrd fa<;ades, its marble stairways and tapes- 
tried walls, came Unit F with Sister Mak'lle S. Welsh, a 
former superintendent of nurses at Peter Bent Brighara Hos- 
pital, Boston, as supervisor and Dr. Howard W. Beal of 
Worcester, Mass., as director. 

In the meantime, Unit D with Dr. Robert W. Hinds, of 
Buffalo, New York, as director and Sister J. Beatrice Bow- 
man, of the Navy Nurse Corps, as supcr\'i9ing nurse, had Ixm-u 
sent to the Haslar Royal Naval Hospital, near IWtsmouth. 
This unit nmained at Haslar for six weeks before it waa*] 
called to Paignton to supplement the staff at "Oldway House." 
A brief description of the Haslar hospital is therefore given 
before the work nt Paipiton of Unit F and the combined wiirk 
of Units F and D is clrtailed. 

Sister Beatrice of Unit D wrote: 

From OHr hotel windows overlooking Falmouth Harbor, 
we paw the Channel and the flfJ Cross as she steamed out, 
and the S. S. Tfnnessft* as she swung into her place. 

At ten o'clock on the morning of October 3, we started 
for (JosiK>rt. Kven th« roads and foliage seemed old-world 
and *|imiiit. Ijuly Tloiham says that Americans are not con- 
sidered fureigners here and indecfl they do not treat us so. 
One wouH think wc were some near relative turning up after 
yeJirs of separation. 

This is tile hirpest hospital, naval or military, in England, 
with a c-a[»aoity of two thousand and six hundred beds, and a 
possible emer^'cncy one of seven thousnnd. Each of the 
ninety-nine wards has twenty-eight to thirty patients. 

Picturesquely sea-going was the langiuige at Haslar. The 
floor was '*the deck," upstairs "top-side," and downstairs "be- 




THE ^ieucy ship 



14' 



I 



I 



L arri 

If 



Ww.** The nurses' office was the **8i8tor'8 cabin," the operating 
room •'the theater," tlie Hospital Corps ''the sick berth staff." 
Small wonder that the American nurses gasped to bear the 
British Navy Sisters ref(»r aoleranly to a critically ill patient 
JS "that jolly sick man just gone below!" 

But it was necessary to supplement the staff at "Oldway 
House." Thus after six weeks of absorbingly interesting work 
at the Naval Hospital, the order came for Unit D to proceed to 
Paignton. 

The ilutron of "Oldway House," Gertrude Fletcher, was an 
Australian woman whose long experience during the Boer War 
had heljK'd pn*pare her for the delicate task of directing the 
work of th«* Entjlish and American nurses. When Unit D 
arrived on November 12, they found that Unit F had previously 
bwn given the care of a ward of sixty-seven beds, one-third of 
entire house. This responsibility was continued, but shifted 
llittt Sister Maltclle Welsh of Unit F i)ecame Mutron's 
first assistant on day duty and Sister Beatrice Bowman of Unit 

ID was appointed general night iratron» Other racuTbers of 
Unit D were assigned to ward, night and operating room 
duty. 
An interesting analysis of the first 1000 cases treated at the 
American Women's War Hospital at Paignton showed that 445 
BMietits were wounded, while 5'20 suffered from miscellaneous 
PJnricTS, such as abrasions, burns, dislocations and contusions. 
On© hundred and' seventy-nine operations, under general 
amwtfaesia, were performed. Of the restiltg of the treatment, 
I «Jj 129 of this first 1000 were pronounced "unimproved," 
523 wore completely cured and only 3 died. "On January 4," 
a nnrsc wrote, **we received one huiulred new eases, coming 
4in*ct from the trenches tlirough Boulogne. One young man hud 
kst both eyes; otliers had terribly frosted feet; two came in 
with perfectly clean wounds, the first we have had; one has 
I et^t biillet wonnds in one leg, another through the shoulder, 
' tbd a sabre cut on the arm, the only case of this tvpe in the 
bo«>itaI," 

At the close of their six months' service, four of the Ameri- 
can nurses, including Sister MaWlle Welsh, asked to Vx* re- 
li' 11 dtity on account of the lightness of the work. In a 

lir _ _ J t'/ased Febrnarj* 23 to ^liss Delano, Matron Gertrude 
Fk»tcber gave a penetrating glimpse of the two stages whicli 
f^WTj nnrsc iu active 8er\'ice soon nndei^oes: 



148 HISTORY OF AMERICAN RED CROSS NURSING 

War nursing as a vhole is a demoralizing experience. As 
long us the work is hea^T, all is well, but wheu long periods 
of waiting arrive, even the most level-headed of women are 
apt to bei^onic lacking in judgment to a degree that astounds 
one. The work begins with guch stirred up emotions and 
enthusiasms, and one can never quite tell where that will lead. 
This is why I regard the second stage of war nursing as 
the test. I have gone through it all before, so it becomes like 
nursing a familiar disease. 

At Miss Fletcher's request, National Headquarters appointed 
Sister Ixtuise Bennett and Sister ElizalK^th Weber as super- 
visors of their n*spective units. With fifteen English sisters, 
seventeen probationers and twenty-six American graduate 
nurses, the nursing staff at "Old way House" had been experi- 
encing difficultii'S of seniority and Miss Fletcher felt that Imtter 
discipline could be secured by having the remaining Americans 
work under their own leaders rather than under British Hurst's. 

During the spring, tlic work grew heavy. Three additional 
nurses and two doctors from the United States arrived April 5, 
1015. Miss Fletcher expressed her relief in the following 
letter : 

The whole of England seems to be preparing for heavy 
times ahead, and nurses apparently are going to be difficult 
to get. Soldiers and everybody else can see no other possi- 
bility than that we must have an immense amount of sidcness 
when the .sunnncr Kcts in. The men say that even already 
while the weather is so cold, tlie odor from the dead horses 
alone is dreadful, and whenever they start to dig a fresh trench 
they come upon the dead. Therefore, it can be nothing short 
of a miracle that will prevent a summer of sickness and dis- 
ease. 

However keen may have been the disappointment of the 
American nurses that they were not always busy to the utmost 
capacity of thfir strength, or however delicate tlie relations be* 
tween probationer, Sist<?r, supervisor, Matron and dinn-tor, the 
work with Tommy Atkins "'imself" was intensely satisfying. 
Sister Beatrice wrote : 

Our patientA had great fun at our expense on Washington's 
Birthday. One of our probationers, a girl from Virginia, 
sent to liondon for some artifu-ial nherries which she passed 
among nil of us Americans and which we wore, greatly to 
the enjoyment of our thirtv-two convalescents. WTien I came 



THE MERCY SHIP 



U9 



on duty the next morning, I fouml every man Jaek of them 
had tied about his neck on a string* an apple, or an orange, 
or a baiuuni. When I aKkt^l what the detorations meant, I 
«ra« gr^U^ with this answer: *'\VelIj yesterday being George 
WafihinKtoTi's birthday, we thought we'd celebrate Adam^s 
and Eve'a today I'' 

To the white beds filling the reception halls and guest rooms 
of that stately palace-hospital came soldiers from the Seven 
Seas. Princeas Pat's trooper lay beside "those blaok Gurkhas, 
a fine lot of men they be." Blackwatch and Patriot sunned 
ibemselves on the terraces, or limped through the gardens. 
The patients delighted to write poems which they presented 
U> the uursea. Among the popular subjects was "rrozen Feet": 

Tingle, tingle, little toes. 

Them wotV 'ad 'em only knows 
Nothin'g pleasant, nothin's sweet, 

*Bout a flair of frozen feet ! 
Standin' in trenches wet an' cold 

Is wot 'ft eautied 'era. so Tm told. 
They throb all night, iun\ burn all day, 

But are cured by friends from U. S. A. 
They work ail ilay and watrh nM night. 

To do their bit to get chaps right. 

A Corporal of the King^s Own Regiment. 

Spring came over the Devonshire hills, bringing splendid 
CanadiaD tr<X)ps to Paignton, some of them blinded, others 
choking with poison gas, and the horror and weariness of war 
IfTCw harder to benn "Wo don't say much ahout it," wrote Sis- 
ter Lotiise, *'but we are all heartily sick of this endless cruelty 
and wickedness." The monotony of ten mouths' continuous 
duty was broken by vacations and short trips about England. 

The American Ambassadors in the various belligerent coun- 
triei received word August 1 that the American Red Cross was 
withdrawing its foreign units on October 1, owing to lack of 
fuida. With a record of l!)Or> adniissious during the period 
ihe American W<>men*8 War Hospitjil was op<iruted by Ameri- 
mn lU*d Cross, Units F and D withdrew Septemlx^r liO, 1915. 

Early in the spring of 19ir>, the American Red Cross had 
usign«d two imits to the Belgian Government Ui assist in the 
care of tlieir wounded at La Panne, Belgium. The personnel 
of the S. S. lifd Cross were recalled after a year's foreign ser- 
vice, but tliefle later units were retained in Belgium until the 



150 HISTORY OF AMERICAN RED CROSS MRSING 

completion of their entire twelve months' duty. Several nurses 
of the Units D and F were accordingly transferred hj Miss 
Delano to La Panne. Five otlier nurses remained at the invita- 
tion of the British War Office at Paignton. Other memlHTS 
of the units returned eveutuully to the United States. 

In a sunny valley below tlie Pyrenees lay the city of Pan, 
France. The French units A and B of the Mercy Ship Expedi- 
tion were detailed for duty at this famous winter reaort. Dr. 
Ke^aiold M. Kirby-Smith, of Sewanee, Tennessee, and Margaret 
Lehmann, of Philadelphia, were in charge of Unit A; Dr. 
Koades Fayerweather, of Baltimore, ilaryland, and Alice 
Henderson, of Baltimore, were in charge of Unit B. 

On their arrival, October 3, 1914, at Pau, the American 
surgeons and nurses were greeted by the mayor and residents of 
the town and by many ^Wericans then living there. "Pau is a 
prosperous little city," wrote Sister Alice Henderson, *'cvory 
one aeems quite well-off and prices on food and clothing have 
advanced little, if at all. Were it not for the soldiers on the 
streets, one would never know that a war is raging." Since the 
hotels were all liable to be requisitioned for the soldiers, the 
Palais d'lliver, a pleasure-designed casino, was secured and 
equipped as a hospital 

The Winter Palace had formerly been the center of the 
great gayety of Pau and its rooms and corridors were large 
enough to accommodate 166 patients. In the center of the palace 
was a palmariura ; the Americans put long tables down the 
middle of the room between the palms and blossoming vines 
and the convalescents had their meals there in the wann sun- 
shine. Every window of the Winter Palace commanded a view 
of the whit<* Pyrenees which loomed above Pau. 

Although the nurses were all American-born, some of them 
had names of Teutonic origin and the French felt and even 
expressed some doubt as to their sympathies. This was one of 
the reasons why the units were assigned to southern France, 
instead of to Paris, where professional nurses were greatly 
needed. Paris was the headquarters for the Government and 
the Army. During the first weeks of their stay at Pau. the 
Americans received few patients. However, they scion earned 
the coutidence of the Ineiil nuthorities. **We are not only 
wantedt'' wrote Sister Eiunm, "but we are needed. I do not 
think that we will be moved nearer the front," she added, "it is 
easy to understand now why we were sent to Pau. As iudlvid- 




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161 




on our own rcaourcee, it might have been possible for us 

work Bt the front but as an organization representing a 

neutral government, this appears to be quite out of the question." 

finally in the last day» of November, nmuy wounded were 

to the Palais d'Hiver, Arabs, Belgians, Moroccans^ AJge- 

and French were unloaded from the hospital trains. 

**One has little idea of what this war really is," wrote Sister 

Alice, after a oouvoy of 110 wounded had arrived, *'uutil you 

•ee a train of wounded come from the frunt, the men so dirty, so 

t^ggsdj so tired^ 90 sick, yet not one of them ready to admit that 

he Lb cither hungry or exhausted or that his wound is more 

than a scratch!'' 

Christmas in France during this first year of the war was a 

of anxiety and sutTering, The drive on Amiens was in 

; every province was sending its men to the defense of 

douce trrre de France. As Pau was a recruiting center for 

• the surrounding country, the streets swarmed with soldiers of 
etury class and type. From her busy operating-room, Sister 
Emogene E. Miles wrote on December 20 : 

H This past week has been Had. Our ears are filled with the 

B eomid of drums, of bugles, of marching men. They are 

^^^H mohiliiting all the available recruits for the January drive, 

^^^V ealhng tH:>ys eighteen years old, though volunteers of sixteen 

^^^B are accepted. Dr. Kirby-Sniith was abseut one day la^t week 

^^^K and he tells us that at every station on his way home were 

V mothers briuging their sont^ to the train. After it had pulled 

I out, many of those poor youngsters would weep, their heads 

H beot, yet unashamed. 

H Pau has tremendous barracks, now filled with men and 

H boys getting into uniforms, drilling and being sent off to the 

H Army at once. They are in sore need of more men. When 

H the soldiers go to the train, their friends meet at the barracks 

H and thrust a bouquet into each gun. 

" A train loaded with wounded came to Pau on December 21, 
direct from Amiens. Before the arrival of these grands blesses, 
• notice had been posted from the chief me<lical officer in the 
Btparinn'nt-Baiises-Pyrenevs, stating that in future consign- 
tacnia all seriously wounded men were to be sent to the Ameri- 
can Eir«tpitaK These patients had truly undergone the rigors of 
trench warfare. One man's mud-saturated clothes b<ire out his 
itareoiKnt that he had been standing in water-filled trenches for 
thiw weeka. Many of the patients coming from crowded hospi- 



152 HISTORY OF AMERICAN RED CROSS NURSING 

tals further up tho line, had 8h>ughing bedsores. A desperate 
case of tetaiiMS, which roqniivtl sptx-iiil nursing day and night 
for several works, recovered, to the vast Kurprise of tlie French. 
Although the First Aid dressings were uniformly ejceellent, 
the majority of the wounds were badly infected. This infection 
was caused by mud-soaked uniforms full of bits of straw touch- 
ing the wounds l)efon» the dressings could be applied. 

The hospital at Pau occupied a geographical position which 
increased the professional difficulties of the American units. 
Although they were near enough to the front to receive patients 
forty-eight hours after injury, often with only First Aid dress- 
ings on their wounds, they were also far enough back in the 
eone of the base to be the cynosure of many tourists' eyes. 
Sister Alice wrote: 

We must always be on dress parade. The scores of Eng- 
lish, FrcjU'h and American visitors who come to visit us 
each week make it necessary that we keep the hospital ready 
for inspection at 'any moment. At the present time, I am 
satisfied that we are doing all that we cruiM hamlle efficiently. 
Were we in some isolated place, or at the line, we could easily 
take care of many more patients. As it is, however, we seem 
to have made a lasting impression on the French in demon- 
strating the value of trained nursing as opposed to volunteer 
effort 

The American units found their French patienta courteous, 
appreciative and simple, with the itaivcie of children of tlit? soil. 
Robert Herrick, then American Ambassador to France, wrote 
tlmt **the jMipular nickname of poilu, the unshaved, has uu inti- 
mate signitieanee. The little French soldiers are not parade 
soldiers, but cctmmon, plain men, careless of appearance." ^ 
BarbusHc descrilx'd in I^ Feu the characteristics which so en- 
deared their patients to the Americ4in nurses: 

They are not soldiers, they are men. They are not ad- 
venturers, warriors for massacre, butchers or driven eattk*; 
they are pluughnion and laborers, easily recognized as such 
tinuer their uniforms. They are up-rooted rivilians. In their 
silence, in their inmiobility, in the masks of superhuman calm 
on their faces, reflection and fear and longing are visible. 
They are not the sort of heroes they are popuUirly supposed 
to be. but tiieir nacriHee is nobler than those who have not 
seen them will ever \}C able to divine. 
•*Po#»iM'» rfrt PoitUM," \\. A. Buttcrfleld, Boston. Mum., p. 3, 



THE MERCY SHIP 



153 



iBister Emma wrote on December 31 that a man in her ward, 
father of four babies, had received not one word from his 



I 

t 



I 
I 



wife 



the 



fiixiee uie war began. Another young man> she wrote, 
iDemed dazed after his thirty-two days in the trenches, where 
be had slept only in snatohes, always drinking bliu^k coffee to 
keep awake. "He returns very soon. It is drcndfnl to hear 
bim say with a ahmg of the shoulders: *Eh hien, 1 shall soon be 
dead, — I go for France,' We see only mourning on the streets. 
The wtimen do nil the work, driving oxen and mules, plodding 
ihmiigli mud and raiti drawiug loads of produce to the city, 
delivering bundles of wood and sweeping the streets. Every 
day more men go to the front.'' Always grateful, always re- 
spectful, always apprctciative of the slightest attention, never 
forpetting their mrrci ht'aucoup, never failing in their sympathy 
for llieir fellow wounded, the French stjldicrs were the wonder 
and iuspiratiou of all comers. Sister Margaret wrote: '*It was 
always a beautiful as well as a most touching sight to watch 
the csouvalescents welcome the new blemses. They hail them 
hihiriously, tilling them of the good care they arc to recenve, 
assisting us in making our French understood and helping 
gcnenilly in making the newcomers feel comfortable and at 

When a soldier died at Pan, it was the custom for one surgeon 
and two nurses to attend his funeral. First marched the 
veterans of the little city, old men scarred in former wars for 
Frances then tlie slow chanting priests, then the military escort. 
As very few poUus t'ould be attended to their last sleep by mem- 
bers of their immediate familv, the American doctor and the 
two uurws walked slowly before the llag-draped casket Sister 
Vaahti Bartlett wrote: **A1I along tlie way, tlie black dressed 
wtutten and children stood at attention. Even small boys of 
tve and six would drop their playthings and remove their caps. 
As vns walked slowly down the road to the burial ground, 1 
thonght of the thousands of dead on the battle tieJds, denied 
eron this last p*w)r lumiage," 

II was a sad day h<»th for patients and nurses when a stildier 
vas dismissed fnun the American Hospital. Every one soon 
knew i^vvry one else in this small family of theirs. In a letter 
to Miss Delano, Sister Vashti enumerated her patients: 

Xo. I having t)een a waiter in London, Bpoke English; 
No. II, LcH^horet:, always ready to help, comes from northern 
France, now under German occupation. When be was told 



154 HISTORY OF AMERICAN RED CROSS NLTISIXG 



tlint he must leave Pnu, he had no plaee to spentl his precious 
eight davV leave before returning to the front. As Trench 
BoldicTS receive onl} one cent a day, when one's family could 
not send one money, c'est dommage, n'est-ce past 

No. Ill, Chuzel, the hahy of Salle D, ]»oldfi the record for 
having killed sixteen Gernians. 

No. V, a twenty-one year old sergeant, is a veteran in hos- 
pital experience. "Yon know. Sister,'* he said solemnly, "to 
be wounded twice means to be wounded thrice^ and then one 
is killed and goes — who knows where?" 

As the busy winter months slipped hv in the daily routine of 
hospital life, little if any W(»rd frt»m the other Rod Cross nnits 
scattered over Eunipe came to the American Hospital at Pan, 
A cablegram frnni Major PattorBon, at National Headquarters, 
brought in the latter part of February, 101'), however, serious 
news of Serbian Units 2 and 3. A severe epidemic of typhus 
was sweeping Serbia. Every member of tlio commission at 
Gevg(?li save five had been infected. Until additional assistance 
e^nld arrive from the United States, would not one surgeon and 
three nurses from Pau report immediately at 2Cish i 

Every one of the American family volunteered. Dr. Kirby- 
Sniith, the senior director. Sister Margaret Lehmann and 
Anna V. Lofving, of Philadelphia, and Sister Rebecca Watson, 
of Baltimore, were chosen and left Pau in March to sail on the 
Calidomcn from Marseilles for their destination in Serbia. 
After their departure, Dr. Roades Fayerweather took charge 
of the Pahiis d'lliver as senior director, with Sister Alice 
Henderson as supervising nurse. As other vacuneies occurred, 
surgeons and nurses were assigned to till them from Washington 
or were transferred from Paigiiton. 

With a rf'c^^rd of having treated 598 patients to a conclusion, 
the Pnlnis d'lliver was clo8i»d on September l«t, li)15. During 
their twelve months of duty at the Palais dllivrr more than 
225 major, as well as innnmerable minor operations, were per- 
formed. Throughout their stay at Pan, the American surgeons 
and nurses were greatly assisted by the untiring courtesy and 
cor»peration of Mayor Alfi-ed de Lasaence and his daughter, 
Mmc. de Cabrolc. Mrs. Henry llutton, Mme. dc Arizcun and 
Margaret Porter, American women living in France, had 
charge of the sewing room of the hospital and did splendid 
work- Mrs. [>eonard Brown, Mrs. Wadsworth I^lgc^8, Presi- 
dent of the Comite dea Dames, Mrs. John Gushing and Mr. 



THE MERCY SHIP 



155 



P 

I 



k 



O g ^t A. Buckliu, Jr., the American consul at Bordeaux, 
pratly furthered the work of the American units through their 
pcrsi»nal service and interest. 

Kief, whieh was a elearinp-house for thousands of Russians 
IfDunded^ is situated on the Dniejwr River, with tlie Black Sea 
to the southward and the Carpathian mountains to the west. 
This RuKsiau eity was the destination of Units C and H of the 
Cn)ss Merry Ship Relief Expedition. 

Uniti* C and H left the S. S. Hed Cross at Falmouth TIarhor 
for London on Wednesday, September 30, 1914, and started the 

;t day on their long journey for Petrograd via Scotland and 
North and Baltic Seas. 

When the crowded little steamship Balder docked at Gottcn- 
burg, Swt»den, the Americans were met with the cordial welcome 
which w«d t<> characterise their reception all along the way to 
Kipf. A hrief stay at Raumo, Finland, was made pleasant by 
the ci.>rdial hospitality of the population. This Finnish village, 
then used as a p<)rt of landing for refugees, boasted no hotel, 
The women prepared fmKl, however, for the passengers of any. 
ship which came to their wharves, and on many days fed more 
refugi?eB than the town had inhabitants. The American siir- 
giaonB and nurses breakfasted in snnill groups at dilferent houses, 

A representative of the Russian R*Ki Cross escorted the unitB 
fpoin ilaiuno to Petrograd. At the capital city of Russia, the 
Hooomble Ge^jrge T. Marye and his wife and Mr. Winship of 
tbe American Embassy, acted as hosts. Her ilajcsty, the 
Dowmger Empress ilarie Feodoroma, who was the head of the 
RluviftQ Red Cross, received the Americans at the Illagcn Pal- 
ace, Le«t the field uui forms of the American Red Cross, not 
ibon BB familiar as they grew to be in later years of the war, 
should fail to be rt^ognized and the work of the units accord- 
ingly hindered, the American surgeons were given high rank as 
medical officers in the Russian Army and the nurses were pre- 
acntnd <M*rtitieate8 as Russian Red Cross Sisters. 

At last on October ^8, Units C and H set out for their final 
destination, Kief, a five days' trip of nine hundred miles. The 
8p«*cial tnxip train on which they traveled drew freight cars 
containing furniture, linen, kitchen and laundry supplies for a 
40<»-U*d hospital and four car loads of American Red Cross 
medical supplies from the United States. 

Dr. William S. Magill was senior director of the Russian 

its and Sister Helen Scott Hay was senior supervisor. Dr. 



166 HISTORY OF AMERICAN RED CROSS MUSING 



Phillip Newton, of Washington, D, C. was director of Uni 
II and Sister Lucy Minnigerodc, one time superintendent o 
the City General Hospital, Savannah, Georgia, and later o: 
Columbia Hospital fi)r Women and Children, Washington, 
D. C, was supervising nurse. Dr. Edward Egbert, of Wash 
ington, D. C, was director of Unit C and Sister Chariot 
Hurge.Hs was sup(^rvising nurse. 

During November, the units set up an American Red Croi 
hospital in a wing of the Polytechnic Institute, which crowned 
the crest of a hill just outside the city of Kief. On the first 
floor, they established administrative offices, pharmacy and^ 
living quarters. The second and third stories were utilized ai 
operating and dressing rooms and as wards. In the basement, 
large rooms were given over to the reception of patients; an 
an efficient system of baths, which awakened the interest o 
many other hospitals in Kief, was set into operation, 
incoming patients received a bath, a haircut and a shave fro 
the mniinrs before they were admitted to the wards upstairs^ 
Seriously wounded and helpless cases were sponged oflf by th 
nurses in rooms adjoining the main baths. 

To transform this school info a hospital ret^uired not onl 
equipment but genuine hard work. The nxiuis where the wardtf 
were established were large, with high ceilings and many win- 
dows; tlie amount of scrubbing necessary was consequently 
groat. On one occasion the Red Cross officer who purchased 
supplies for Kief, sighed when he aaw Sister Helen Scott Hay's 
shopping list. "Holy fathers!" he ejaculated, "1 think that 
Sister Helen actually eats scrub brushes! Tve Iwught about all 
there are in Kief now!" In one of her letters to iliss Delano, 
Sister Helen told to what use these articles had been put: '*I 
wish you might have seen your Amtrihiu Spit Cfstritza 
scrub! Some say we have lost face thereby; but what our 
twenty-four nurses did to those dirt-littered wards is a poem 
in itself and u subject right worthy for epic or knighthiHid !'' 

After a month spent in preparation, the hospital was formally 
opened in DecemlHT, 11)14. The majority were sent up from 
the Austrian Front, the Carpaths, as they called it; Siberians, 
Great and Little Russians, Poles, Tartars, Ressarabians, Gniz- 
ins and Cossacks from the l)on and from the Caucasus lay in 
the white cots and thanked the Amcricnn Sisters for their ser- 
vices with simple, courteous, heartfelt expressions of gratitude. 
Sister Lucy Minnigerode wrote: 



I 



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157 



but nmaaged in three 



I 
I 



They tell us stories of the war, but never speak of their 
cxperieDces as a hardship. One man described having been 
wounded at a plaee the noldiers call ''the niouutaiu <if death/' 
He lay araong the bodies of his eompany on the field for five 
Hays, giving himself First Aid, before the firing lifted 
enough for anyone to bring him in. Another owed his life 
to a peasant woman, to whose shell-ritied hut !ie had crawled. 
A third w&a buried in a trench for dea<i 
cbys to dig himself out.' 

The American Christmas, with its carols and tree, and thir- 
teen days later the Kussian holiday, celebrated by a second tree 
Aod a vaudeville show for the patients, came and went in the 
busy mutiue of hospital life. The big Polyteeiinieal Institute 
Hospital was operated under a nursing schedule of nine hours' 
d^y duty and ten hours' night duty, of two weeks duration for 
the American nurses, and ten days duration for the Kussian 
Sist<>rs. 

The c»ming oJ many visitors to the American Red Crosa 
Hospital at Kief made necessary the same **dress parade nurs- 
ing'''' as at the Palais d'Hxvtr in Pan. A large medical school 
nearby sent its stxidents in groups of twenty and thirty to see 
the worft of the American surgeons and nurses. Visiting Army 
officers of high rank came to inspect the institution. One asked 
if the Si&ters were good to their patients. A soldier replie<l: 
"Not good, — do\ible good!" A ranking general inquired how 
■>ldiers managed with nurses who eijuJd not speak their lan- 
l^age. A big Giasack answered him: **What need to speak, 
Exo^llency^ They do everything for ns without askingl" 
8is(€r Lucy wrote of the contidence with which the Kussians 
regarded the Americans: 

The patients themselves were quick to realize the difference 
in the nursing service given them in the American and in the 
Russian hospitals. Neither ]mtient, sanitar nor TtuHsian sis- 
ter would have been willing to return to the way of caring for 
the wounded to whieh they had been accustomed. Letters 
from ex -patients testify to their appreciation ; to their willing- 
neas to help as far as they were able; to their patience under 
terrible suffering and after months of extreme hardship; to 
their unselfishness with each other and their gratitude for 
any service rendered. 

•**KiptTicnwe of Unit C at Kiel, Russia." I*ucy Minnigerode: Red CrMS 
Dvpartmeot, American Journal of Nurnng, Dwvm\teT, 1915, Vol. XVI, p. 



158 HISTORY OF AMERICAN RED CROSS NURSING 



Of course, many individual cases of special interest de- 
veloped. The top sergeant wlm had part of his jaw and all 
of his tonpue sliot away and who lingered hetween life and 
death for many weeks, linally recovered and remained in the 
hospital to tciich others, wounded in like manner, !iow to feed 
themselves and to keep the mouth properly cleansed. The 
first blind soldier, who with the aid of his comrades' direc- 
tion learneil his way ahout the hospitnl. taught others, hlinded 
like himself, how to keep themselves and find their way about 
without assistance. Courage, endurance and a blind deter- 
mination to get well were potent aids toward recovery. 

The oTgauization and personnel of the "units underwent im- 
portant changes following the termination of the first six 
months nf aerviee. Dr. Magill had been relieved from duty, 
NovemlxT 7, 1J)14, and the iinita had been without the guidance 
of a general medical director. A more satisfactory unity of 
command was secured upon the arrival in April, 1015, of Dr. 
H. H. Snively, of Columbus. Ohio, us senior director. Six of 
the original nursing statf had left Kief in March, 1015, to 
return to the United States and eleven relief nurses arrived with 
Dr. Snively. Further vital changes oceuiTed in June, Sister 
Helen Scott Iluy left Kief on .luue 2 to invostigatc the schcud 
of nursing project in Bulgaria. Sister Minnigi^rodo with 
two other members of Unit C returned to the Uuit(»d States in 
June by way of the Pacific; mines in the North Sea and sub- 
marine warfare endangered the shorter route. Sisters Char- 
lotte BurgC88» Alma Foerster, Rachel Torrance and Alice Gil- 
bourne were transferred from Kief to the Serbian units. 

The remaining surgeons and nurses settled down to a summer 
of strenuous activity. Sister Mabel Ilich became su]vrvisor of 
Unit C, Sister Sophia Kiel, supervisor of Unit IT. The hospi- 
tal was increased on the first of July from 400 to 500 beds. 
The anticipated activities ou the Polish Front did not take 
place, however, and the ominous lull gave opportunity for the 
tired surgeons and nurses in Kief to take welcome vacations. 

Of the aeecunpliahment of the units at Kief, statistics show 
that the mortality rate of the American Red Cross Hospital was 
throe and seven tenths (3.7) per cent.* During the nine months 
in which this hospital was maintained under American manage- 
ment, 4050 cases were adniittc<i, 07(» major and 53,2;i3 minor 
operations and dressings were performed. 

'Amcricftti Red CroM Anniidl Rrport, 1015. p. IS. 




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159 



I 



* 



Wlien the Ameriam Red Cross recalled its foreign units in 
OctolM»r, 1015, the American family at K'wf separated into 
imni] groups, eaoL going its own way. Several of the siirgeona 
tnd nurses returned to the United States. Dr. Phillip Xewton 
took charge of a flying field hospital in the Russian Anny. Dr. 
Snively, with Dr. Brown SrcCliutic, Dr. T. Lyle llazlett, 
Sophia Kiel, IL Lee Cromwell, Florence Farmer, p]dwiua Klee, 
Uary llill, Aurel Baker, Margaret Pepper, Clara Bamdollar 
and Eleanor Soukup undertook service with tlie Russian Red 
Cro«, They were sent in November, 1915, to establish a 200- 
bed hospital for Russian soldiers at Khoi, Persia. In this an- 
cient city seventy-live miles from a railroad, with its narrow 
arciied streets and its curious bazars where merehants, witli 
long beards dyed red, squatted on rich carpets and cried their 
tmrcs^ the Americans set up a Red Cross hospital. The build- 
ing they used was a low adobe structure in which camel drivers 
Ikad housed their caravans. On February 12, 1D16, the -limeri- 
wms left Khoi for Kasbin, Persia, where both a military and a 
Red Croea hospital had been established. While here, Sister 
Eletnor had a rare opportunity to leani something of Persian 
customs: 

The Pereian house was a mass of mud walls with a flat roof, 
built around a ciiinpound and surrouiirh'd by a tun foot mud 
wall whirh exthnles all view of the yard ur harem. Kntrance 
»*as through a strong wooden gate in (he wall, always attended 
by a kee|>er. 

The patient was placwl upon two narrow tables in a damp, 
cold room, and a Ca»sarean aection performe<l in the midst 
of her entire family and a mofla who prayed all the time. 
Ah tables, chairs and beds are not found in Persian homes, 
when the operation mus over, the patient was put into a bed 
contii^tiug of a narrow mattress laid upon the floor. Every 
family, whether rich or poor, possesses many exqiiisitf rugs. 
Presuming that all water was brought from the well, I 
hadn't given tliis much thought, but one day when going to 
the house, T noticed at the small stream running through 
the middle of tiie street (scarcely wide enough for a team 
of horses), a woman washing clothes by beating them with a 
dub; further down a mother was bathing her cluld and yet 
further on a young girl cleaning the head of a shee]> for some 
future meal. When I arrived at my destination, the serxaut 
was dipping up in an earthen urn water for cooking and 
drinking. This shows how rapidly cpiiiemics may spread, as 
Te saw later when cholera broke out. 



160 HISTORY OF AMERICAN RED CROSS NURSING 



We had another patient, a Persian woman recently mar- 
ried, who had made an attempt at suicide bj taking large 
doses of opium and strychnine. After several days she re- 
covered enough to tell us that her husband whipped her. 
She resented it very much. He, however, wa.s present and 
said he heat his wives once a nuuith whether they needed it 
or not just to show them their place. Tie divorced her the 
next day by commnndinf^ her to go away with her dowry.* 

Again on Mareh 24, tho Americana moved, this time to a hos- 
pital eHtablished in a carpet factory in Hiiinadun. A special 
detachment, consisting of Dr. MeClintic, Eluuuor Soukup and 
a Russian Sister, startetl in April to Kcrnuuishah for surgical 
work at the front, but the. advance of tht* tierce Kurds in .tune 
drove them bacJc, after many adventurofl, to Kasbin. The fur- 
ther record of the work of these Arnerik-nH.skti CeMriiza in the 
Persian desert, colorful, vivid, full of the swift dangers and 
Butferings of guerrilla warfare, became no longer that of an 
American Red Cross unit, but was merged into the record of 
splendid achievement of the many men and women who carried 
on individually tlieir service for the wounded in the European 
War. 

The smoky city of Gloiwitz, situated in the wealthy province 
of Silesia, that Uiick finger of Prussia which extends southward 
between Austria and Russia, was the destination of Unit I. 
Unit G, the second of the two detaclunents assigned to Germany, 
was destined for nearby Kosel. 

The Red Cross Relief Exjx'dition of 1914, it will be remem- 
bered, was comprised of ten units, two of which had been 
assigned to each of the live belligerent nations. The detach- 
ments deatined for England and Russia had left the Mercj 
Ship at Falmouth. From the decks of the S. S. Red Cross as 
she lay in the yellow waters of the Gironde River, France, the 
units destined for Germany and Austria watched the surgeons 
and nurses disembark for Pan, France, So, with four remain- 
ing uuitB, the lied Cross weighed anchor October 4 for Rotter- 
dam, her tlnal port of entry. At last the Mercy Ship steamed 
up tlie Maas River, through level Holland fields. The Ameri- 
can nurses as they leaned along the rail, exclaimed witli pleasure 
at the picturewjiie s^'cne, tl»e windmills and the childnni who 
clatti^red along thir banks in their wooden shoes pointing with 
deliglit to the great Ri'd CVrtts on the ahip^s white sides. 

•"With tht* RuMftinnn in I'lTflin," Ki**nnor Soukiip Mi-Clintif, Hmrrtcxin 
Journal of Svraing, Vf»l. XVIM. j)«uf SI». 




THE MERCY SHIP 



161 



The four units were formally welcomed at Rotterdam, Octo- 
bcT 10, by the Prince Consort, president of the Dutch Red 
Cross, Dr. Henrv van Dyke, American Ambassador, and the 
German and Austriau ministers at The llague paid visits. 
Sister Anna Reutiuger wrote of the refugees pouring down 
trrufis the frontier into Holland a few hours before the fall of 
Antwerp : 

From painting and histories we had visualized war as a 
tniggk' between manly foes, both victors and vaiujuished dis- 
playing heroic qualities that stimulated the imagination and 
mt the blood coursing rapidly through the veins. That was 
the false and artificial glory of war. Now we began to see its 
real, ugl^j hideous features. Here were aged men driven 
from their country, their faces reflecting their misery and 
deepftir; here were desolate women whose fathers, husbands, 
fions and brothers were held as hostages or shot as suspects by 
a relentless conqueror; here were children emaciated, gaunt 
and hungry, — all homeless outcasta. 

Under the personal guidance of Count Helie de Talleyrand- 
Perigord and of Baron Goldschmidt RothscbUd, the four units 
led October 10, 1014, for Berlin. There Units I and G 
company witli the Austrian units and started on their 
trip acrr>ss Germany to Oleiwitz. 

At noon of Octtdxr 17, the long supply train earrving the 
Red CrDSS siirgwnis and nurses pulled into the grimy stntinn of 
Glciwitz. As they had nt'Hrcd tlu-ir destiiiHtion, tin* iiursi*a had 
eJU-laimed at the smoke and coal-dust which hung in a blue haze 
over the pine and birch forests of the heavily-wooded country- 
side; and now that they arrived, they looked about with curious, 
delighto«l ryes on this busy city of 70,000, the center of the 
rich mining and manufacturing interests of southern Prussia. 
Here Unit G left Unit I and proceeded forty miles further to 
Koael. 

The proverbial German system was at once in evidence at 
^teiwitz; the Americans were immediately escorted on an in- 
rtiou tour of the public buildings available for hospital pur- 
The military* authorities allowed die Americans to 
the JocHtion of their future Lazaret. The city theater, 
could accommodate sixty-two patients in the downstairs 
)y and sixteen in an upper reception room, seemed to con- 
the best poaaibilitiea for development and was taken over 
by the unit* 



162 HISTORY OF AMERICAN RED CROSS NURSING 

Unit I went on duty October 18. Dr. Charles H. Sandei 
of Calvert, Texas, was director and Sister Anna L. Ueutiiifr** 
formerly Directress of Nurses, L>nng-in Hospital, New Yorl 
City, was supervisor. Sister Donna Burgar described her h 
pressions of that tirst morning in the wards: 

The theater was a living pieture of the tragedy of wi 
The stage, the hoxcs and the gnllerios were there jnst as yoi 
would see them in any theater at any time, but there were noj 
chairs nor seats fur patrons. In their places stood low slatted 
iron beds covered with straw ticks, a single straw pillow and 
a blue checked IkmI cover. Nearby stood plain piiio tables, one 
for every two beds, in whir-h the last bare necessities of nmiii- 
taiuing life of itian were kept; the dark bread, the daily al- 
lowauee of butter, the knife, fork, spoon, tobacco, soap, pocket 
comb and an oerasioiml toothbrush and always a much won 
picture of the wife, the children or sweetlieart. . . . 

If we did not see orchestra chairs, neither did we see th< 
ordinary theater-goers, dressed comfortably and well, intenl 
on pleasure, with laughter in their faces and joy in tlieir voices. 
In their place we saw many weary soldiers in worn, mud-] 
stained, torn uniforms, with dark dried blood stains tellinj 
the tale of wounds of hours and daj's before.' 

Within a few days Unit T had an opportunity to witness tin 
remarkably swift and thorough "turn-over" of patients which 
characterized the entire German sanitary service. Sister Anna 
Reutiuger de8<Tibed it; 

A few days after our arrival an order came at 8 A. M 
to prepare sixty-five patients for discharge in two hours. 
Withiji an hour after their departure, we admitted sixty-eigh 
now stretcher cases. The arrival of a transport of seriously 
woun4led is an indescribable scene. Their bloodless and 
haggard faces reflected the agony they were suffering. 
Wounded five days previously in a battle many miles from the 
railroad, their Hrst conveyances were spriugless farm wagons 
and LTude home-made carts. In tliese they traveled twenty- 
four hours, without food or drink and were then packed in 
freight cars with little straw to lie upon, getting no sleep and 
a linn'ted amount of food. Their dressings, not changed 
during four days, were stiff and foul. One of our ]mtients 
had been lifted from the battlefield, placed with three others 
in a wugon, jolted over rough roads all night long. He dis- 

•'^n Oleiwitjs/' BonuA G. Burgar, American Journal of Nurting^ Vol 
XV, p. lOtK. 



M 




THE MERCY SHIP 



163 



coviTcd At Hawn tlmt his iximrade had passed away in the 

darknc^**, probaljly from heniorrliagee and exhuustiou. 

The}' lay on the hard iloor of the foyer, since they could 
not be taken into the wards until the Yerniiri-i*overod iini- 
fonns and boot? were removed — thos*» sad-looking uniforms, 
a few days liefore ao spotless and clean, now nmd-eaked, hullet- 
pieroed and blood-t-tained, with here and there an arm or leg 
missing. On arrival they received a cup of hot cutTce and a 
sandwich. The uniforms were put into bags and sent to the 
garriiion hospital for fumigation. The boots, helmets, belts 
and knapsacks were kept in fieparate bags. Often the sol- 
diers' feet were so t-wollen it was necessary to cut the boots 
to remove them. Bathet were given in bed since we were han- 
dicapped by havLuj; no bath tub or available place to install 
one. Fortunately whenever larpe transports arrived, the 
neifjlihors brought in bucket* of hot water and in such cir- 
ciimstAiices tliey were of great value. The first consignment 
of men had worn their xmifornia eight weeks without once 
removing thera. 

At the end of their second week in Gleiwitz in addition to 
their duties at tlie Vlktoria Theater^ Unit I was placed in 
rharjre of two private KUniken, These annexes each accommo- 
dated twenty-five officer patients and were luxuriously equipped 
furnished. The twelve American nurses wert* distributed 

that one day and one night nurse was always ou duty iu each 
A'/iWIr. They were assisted by young Gernmn women of good 
family, Ilclferinnen^ who also acted as interpreters. The 
systexu of volunteers worked well iu Germany ; because of the 
strict military discipline, an order given in a military estab- 
liahiticut was obeved in everv detail. Under an American 
gndtuite nurse^a constant supervision, the wounded received 
excellent care in the face of many emergencies. "Always hem- 
orrimgi's !*' wrote Sister Anna. 

(fleiwitz was an important military center. Sister Anna 
tiJd of the shifting movements of the Russian and GcrrMnn 
iniiic*s : 

At one time the Russians were supposed to be within thirty 
miles of (fleiwitz. Their gims were hojird all night. Men 
and boys from fourteen to twenty-one were ordered to the 
interior. Accompanied by sorrowing mothers they nnirched 
to the station, each allowed to carry nothing but a email pack- 
age. The atmosphere was tense with anxiety and apprehension 
marked every feature. Neither letter, telegram, telephone nor 



164 HISTORY OF AMERICAN RED CROSS NURSING 



person was permitted to leave tlie city for seven days. We 
were notified to be prepared to depart within an bourns warn- 
ing. Gloom and fear had seized tJie people. The troop trains 
were now moving at iifteen minute intervals. They con- 
tinued to pass for five daya and nights, two million men, with 
big and small gnns, horses, supplies and nil that go to make 
up an army transferred from West to East. At tliis time 
Austrian-Hungarian soldiers appeared before homes at mid- 
night, begging for lodging. Twelve apjdicd ni a private dinic 
that had i)een turned over to us and the poor fellows, fagged 
and footsore, dropped on the cellar floor, the only vacant spot, 
and were sound asleep before we could bring tliem straw to 
lie upon. The Germans were again driving the Kussians 
back; and again the freshly wounded were poured into the 
city. 

Gleiwitz being a garrison town our attention was frequently 
directed to squadrons of Uhlans leaving for the front, in full 
war equipment with splendid mounts and uniforms, their 
banners unfurled and 4lecorated with rose^;, the mounted bands 
on dappled greys. They were magnificient bodies of men, full 
of buoyancy, patriotism and eagerness for the fray. What a 
contrast to the unfortunates who returne<l to us wounded, 
vermin-covered, helpless, crippled and maimed for life, with 
faces paled and pinched from loss of blood and with hands 
and feet frozen, arms and legs missing, eyes shot out, bones 
crushed, muscles, tendons and nerves torn, all heaping pain 
and agony upon the sufferer 1 

Sister Anna made brief comment upon the mental attitude 
in which the patients arrived : 

Their lingering death and bodily injuries can be moderated 
to some extent, but what about scars of a soul seared or brutal- 
ized by this awful lust of blood ! I cite one of many similar 
histories of a young university student, twenty-two years of 
age. 1 discovered him sitting alone and apart on several oc- 
casions in an apparently melancholy moo<l. He told me 
finally that he had bayoneted a Russian in a charge attack: 
"It was either he or I and ! regret exceedingly that he did not 
get me. J still feel my bayonet going through him. 1 will 
never knowingly kill again." 

The American imrses described their wounded as Btrong, 
clean, healtliy men, patient, cuuragoous, frugal and childishly 
appreciative. 

Four nurses sailed in February, 1015, from New York to 
relieve members of Unit I, who wished to return to the United 



THE MERCY SHIP 



165 



at the end of their six months' sprvice. The war zone 
then full of danger; one of the relief nuraos, Edith Wood, 
jescribed her passage iu the following letter to Miss Delano: 

The accident to the S. 8. Touraxne furnished us with ex- 
citement for two daya. Of the fourteen vessels receiving her 
S. 0. S. we were the tirnt to reach her, turning hack in a dense 
fog eighty miles from our course. Our captain had to reduce 
speed one-half to nllow La Tourmne in her rripplcd condi- 
tion, to irawl slowly behind us. Sunday afterni^on, two 
French cruisers, called Ijy wireless, came up, swung ahout and 
one before and after, escorted our charge away toward Le 
Havre, We congratulated ourselves that we were not on a 
burning ship carrying 100,000 rounds of cartridges and in 
momentary danger from German torpedo boats! 

All night long we have lain at anrhor in Dover. Torpedo 
boats and destroyers patrol up and down near us, and gray- 
hulle<l battleships slip in and out through the fog. Our life 
boats. ha\e been swung clear on the davits, from the time of 
our entrance in Channel waters. The FiottenLim has her 
name in three great rows one below the other on each side, 
in large letters about four feet square, composed of electric 
lights. As we moved out toward the North Sea this morning, 
the wreck of a liner drifted past ua. 

Cpou their arrival at Gleiwitz in March, the four new nurses 
found that Unit I was in sore need of rei^nforcoments. From 
tljt' ViX-lorin Theater, the American Jled Cross Hospital had 
been moved to a concert house nearby, which accommodated 
140 betls, an increase of sixty beds over the capacity of the 
theater-huspitul. Unit I retained, moreover, the two Kliniken. 
Sister Auuu was extremely loath, in view of the pressure of 
work, to allow two of the four new nurses to go on to Kosel, 
but they were needed equally and had to go there. 

Although Sister Annans letters to Miss Delano were persist- 
cntiv cheerful, the Gleiwilz Unit was not without its ditficulties. 
One hundred and seventy-three beds, always full, taxed the 
Krength of eleven nurses. The ten hours' duty and the lack of 
t common languagi? and of recreational facilities made the ser- 
rice more severe. The presence of the Helfffinnen iu the wards 
loither complicated matters. Sister Anna wrote : 

The first duty of our German JJelferxnnen is to write and 
keep histories, and to assist when possible with ward work. 
I am determined to get on with them in this German military 
hoepital \ 



166 HISTORY OF AMERICAN RED CROSS NURSIX 



What we need are conscientious* skilled nurses who are 
•willing to accept without murmur the rontine work of making 
helpless patientB comfortable, bathing them, making htnls, 
dusting, using our improvised equipment and accepting cheer- 
fully the general discomforts of war. Peace at any price has 
been my first consideration, 

Thp American Red Cross Lazaret Konzerfhmis was closed 
September 'i'^, ]!>15. with n record of 15;J7 cases and the staff 
of Unit 1 received their recall with regn*t. Several members 
returned immediately to the United States. Ten nurses and 
one snrgiMm joined the group which Dr. Snmldy, senior direc- 
tor of American Red Cross units assigned to Austria, was 
organizing for the Gcrnuui Govcrunient, to render relief to 
German and Austrian prisiHu^rs of war in Moscow and Siberia. 

The closing days of the Komrrihaits were as busy as had been 
the first days. Sister Anna's last rep^irt from Gleiwitz to Miss 
Delano descriWd how the patients ct)ntiniied to arrive: 

Vermin-rovered as they are, exhausted and hungry, with 
their wounds undressed for five or six days, to bathe and care 
for these patients is the most soul-satisfying work I have ever 
.done. ^^fl 

We are busier at present than ever. The arrival of a largfl^ 
transport is dramatic. When all else fails, I am prepared to 
manage a night lunch counter! IttM^^ently thirty ravenous, 
wounded, tired souls arrived well after midnight. When we 
had finished ;*crubhing them, I stole some bread and witli the 
jam on hand and seventy huge mugs of hot tea. those weary 
men declared this old Knnzer(haus Heaven on earth! 

Parting with the soldiers was hardest for me. We left 
many seriously wounded from our last frightful convoy; their 
eyes, full of feverish pain, haunt me. 

The ancient garrison town of Kosel lay forty miles from 
Gleiwitz in German Silesia. Here in a military hospital of 
700 \wh\% the American surgeons and nurewM of Unit G upon 
their arrival on OctoWr 17, 11>14, were given the charge of the^ 
main Lazaret. 

Unit G 4]uickly won a place for itself in Kosel. Dr. Bial F^ 
Bradbury, of Norway, Maine, direct<ir uf Unit G, was ap- 
pointed in short order general consulting surgeon of tlie entire 
mililary hospital. Dr. H. II. Newman, of Kiioxville, Tennessee, 
was made gt^neral operator. Within a few weeks of their ar- 
rival, a station of fifty beds was opened in a public school near^ 




THE MERCY SfflP 



167 



Ugtied to Dr. John Laneer, of New York, tlieroby 
_ ftal of IW beds to be cared for by Unit G. SisU»r 
Frances H. Meyer, of the New York City llotipital, was supcr- 
riflor of Unit G. A German Red Crosa sister was assigned to 
ihp Aineriean Red Cross Lazaret to interpret for the surgx\)ns 
and to rt-'cord hisliiriea. 

The even tenor of their days at Kosel was interrnptpd on 
January 7, 1915, when Dr. Bradbury was called home by the 
crilical illness of his wife. Four nurses returned to the 
United States at the termination of their six months* duty, 
March 3. As the Garrist^n Lazaret wa-^ tranafornied in ^lurch 
iiilo a central operating station for Kosel and as all major cases 
rttnaiued five or six days under the care of the Americana be- 
fort» they were returned to their owii wards, the work was heavy 
for llie nine remaining nurses. Dr. Gilbert A. Bailey, of Chi- 
appointed to succeed Dr. Bradbury, arrived in Kosel 
farch 12 with one relief niirse, Sister Caroline Bauer. Dr. 
Xewman succeeded Dr. Bailey as director on April 22. 

Two relief nurses destined f(tr Kosel sailed in July r>n the 
S. S, Noordan, With them was the first Harvard Unit of 
150 fmrgeiins and niirst^s, which has been assigned independently 
of lb? American Red Cn>ss for service under the British 
Expj'ditionarv Forfca. To these two niirsca, after days of 
danger in the war zone, — the Noonhim with her life-lioats 
swung out above huge electric letters which proclaimed her 
neutrality to (ierman submarines,^ — the quaint town of Kosel, 
set among fields of waving grain, seemed peaceful indeed. 

When the Garrison Ijtizund was closed on September 15, 
1M5. 750 cases liad been treated to a conclusion and 27.% major 
operations performed. Only a few of the surgeons and ntirses 
returned to the United States. Drs. Newman and Lien with 
Sister Frances and seven of her unit joined Dr. Snodd^-'s group 
in Berlin for duty among German prisoners in Moscow and 
Siberia. 

Unit K of the S. S. Red Cross arrived on October 14, 1014, 
in Viuona, Austria, the gayest capital city of Europe, to estab- 
•rve Hospital Xo. 8 for Austria's wounded and were 
to a brick and stucco school bnilding in the Johann- 
Iloffnmnn Platz. Here they set up a military hospital of 400 
beds, splendidly equipped through the generosity of the Aus- 
trian Red Crt»ss. Dr. Cary A. Sn*jddy, of Knoxville, Tennessee, 
director. Three American surgiwus, Dr. Fred G. Benton, 



168 HISTORY OF AMERICAN RED CROSS NURSING 

of Owcgo, New York, Dr. Waloott Denison, of St. Louis, and 
Dr. P. A, Sinithe, of Enid, Oklaboina, roinposed bis atalL 
Sister Lyda W, Anderson, of tho Illinois Training School of 
Nursing, Chicago, was supervisor of nurses. 

Wounded soldiers coming by train from the front were 
received in tbc school f^vmuasium, which bad been equipped 
with beds, benobos, bathtubs, showers, diet kitchen, dressing 
room and steam sterilizer. Dr. Snoddy described to Major 
Patterson the arrival of a trau9|H>rt: 

Ambulances drive to th^ door of the receiving department* 
which is capohle of handtiiig llitrty bed and seventy sitting 
patients at one time, Here but nourishment, stimulants and 
medical attendance are given imine<liately. The spectacle 
is one of sulTering, exhaustion, discouragement and filth. 

Next to the physician and dietitian in the receiving line is 
the barber, auil then the chemist conies with his lice-killiug 
applications. The bath stewards are rejidy with tubs for the 
sitting patients and tables fur the prone cases. Tlic record 
writer is busy. Surgeons and nurses stand by in three operat- 
ing rooms, one for aseptic cases and two for septic. The ward 
nurses are at their posts with beds prepared. Patients are 
handled at the average rate of twelve per hour. 

The American Red Cross hospital needed efficient organiza- 
tion and high professional skill as its work was subject to con- 
stant c<>mparis<tn with the iK'St organized clinics of Kuropc, 
such as tliat of Eiselberg in Vienna and Dollingcr in Budapest. 
Sister Lyda's report of Nov(»mI»'r 24 to Misa Delano bore 
testimony to the case with which the Americans cared for the 
woimded : 

This afternoon we are enjopng a little lull after a heavy 
night and raorning^e work. We received a message yesterday 
noiin that a transport would arrive at nine P, M. today. 
They did not come until midnight, but we had them bathed 
and their wounds dressed by three o'clock this morning. 
This is our third transport, about ninety wounded in all. 
They have not been severe cases, but all filtliy with dirt and 
vermin. Many have not had their clothes off for weeks, nor 
have they even bad their faces washed. 

It is the greatest gratification to see them in their com- 
fortahle beds I Though scrubhing frnm thirty to sixty men 
makes us feel we have really done something, the work so far 
has not been so strenuous but that we have been able to do it 
thoroughly. Good and generous equipment makes the work 



THE MERCY SHIP 169 

convenient and comfortable. We no doubt have harder days 
in store for us. Our p-eatept dilTiculty lies in compromiping 
on methods and in adjusting ourselvej; to military regulations. 

Uome-fiickBess was a potent foe w*ith which all the units had 
to combat. "Like cool water to the* thirsty, is the sound of his 
tongue to a man in a far country." Few of the nursea 
in, however, and Sister Lyda urgi-d the nieml)ers of 
lier unit to meet with tact and diplomacy situations that con- 
itly arose because of the lack nf a common lanis:uagr. Al- 
jh they were not in 8>Tnpathy with the extremely practical 
ud systomatie habits of the American graduate nurse as op- 
pnsed to the more sentimental point of view which Europeans 
entertained toward the care of their wounded soldiers, two 
Viennese volunteers of high social standing gave much time 
and energy towards making the Americans comfortable. They 
succeeded well. **Our meals are late and long but very good 
indeed," wrote Sister Lyda to Miss Delano. **Per8onaIly I 
like the life here in Europe, though to be sure it is abnormal 
now. Wien is not the happy city 1 visited several years ago. 
It is in sack-cloth and ashes. They are beginning to resume 
their gayety to a small degree. The Royal Opera and the con- 
cert halls are open again.'^ Sister Lyda^s description of the 
}ttead lines alone, served as an index to conditions: 

The husbandry of foodstuffs was more carefully considered 
a£ time went on. Bread was issued at bakeries, restaurants 
and hotels only upon prt^sentation of bread tickets. These 
cards allowed one a week's supply. Flour was obtained in the 
same way. This law was rigidly enforced. On Tuesdays and 
Fridays no meat could be purchased. Cream could not be 
taken from the milk. Peasants harboring their crop of meal 
were all required to give it in to the general supply for com- 
mon distribution. Bread lines formed, extending the whole 
length of the block, forenoons and afternoons, at the several 
hundred stati{»nfi in the city, people waiting hours for their 
allotment of breail. This was a heavy, black bread made from 
potato flour principally, and could be prepared so as to be 
quite pabitable, but when made very cheaply, was heavy, black 
and sogg)'. Foodstuffs had more than trebled in price during 
our year in Vienna. 

Supplies of all kinds, so much wanted last winter, will be 
mtJch more nee<led this winter. Some months back they issued 
a call in Vienna for all the old linen to be used, when frayed 
into ravelinga, as a substitute for absorbent cotton. House- 



170 HISTORY OF AMERICAN RED CROSS NITISING 



wives were required to give up all copper and brass utensils 
to be melted and sent to uniituinition factories. Some Ppleudid 
heirlooms, beautiful Hustiaii samovars and orieutal urns were 
sacTificed. Au especially designed iron finger ring worn by 
anyone signified ihni thi^; jwrson bad tbrown n jewel into the 
colTer and accepted thiti war dwioration instead." 



i 



One year later, horse-flesh was selling in Vienna at tifty-su 
cents u pound ! 

Dr. Snoddy gave Jlajor Patterson an interesting analysis^ 
of the effectiveness of projectiles as shown by the first thousand 
eases which cauie to Rcsi-'rveSpital No. 8. He judged that the 
high velocity ritlc bullet was the most destructive from hand 
weapons. Distingtiishiiig features of the German, Austrian 
and Serbian bullets were lead cores, ogival heads and flat tra- 
jectories which deformed easily. The Russian bullet, conieal- 
pointed and of smaller calibre, was generally less harmfuL^H 
The French bullet, large in size, of solid brass with higfa<B 
penetrating power, did not easily deform. Shrapnel shells were 
by far tlic most elfective of projectiles from artillery. The 
octagonal iron balls used in Frencli shrapnel were more destruc- 
tive than the lead nr alloy balls iif the other nations. German 
Iximba lired at short range from mortar guns threw many frag- 
ments of shell when exploding and literally swept the enci 
down.' 






The American nurses found the German-speaking Austrian 
soldier particularly appreciative, quiet and obedient. Sister 
Lyda wrote: 

The Austrian soldier atrepts the war submipfiively, as the 
inevitable, never questioning for what he is fighting, or 
whether the sacrifice of his precious life is adding to the 
glory of his country or ie fulfilling anything of value to the 
world. Seeing troop after troop of the best men of the coun- 
try, as fine a^ the world has to offer, talented men often of 
great minds, nianhing out daily, few to return and these 
few maimed and uwlcss citizens, one wonders that it did not 
stir anarchistic feelings." 

***Kxf>rri«-nrpR nf ITnit K At Vienna, Aufitria,*' a paper read fay Lyda W. 
Andersuii nt the Eleventh Annual Meeting ol the American Red Cross, 
l>w.*-mlK'r 8, 1!»15. 

' '*Xoti"F on the Kuropcan War." Cary A. SncnMy, Red Cmita Archirea. 

'Pat»*r read l>y Lyda Andereon before the Americau Red Croas Annual 
Meeting, 191C. 



THE MERCY SHIP 



171 



Altliough Unit K was among the most successful of the 
units scut ttbroBcl on tho Red Cross Ship, Sister Lyda had to 
conf(-w( that even lu this detachment, there were moments of 
dist'ouragemcnl : 

I mupt admit that this position of supervisor has raused 
me more anxiety than other poeitioiiB I have held of far more 
grave responsibility. That a number of graduate nurses who 
have hved an independent life for several years are not going 
to adjust themselves to new and unusual eonditlons, sueh as 
we found here, or come under authority (even though the 
su[K-r\isor tries not to make this autliority fiU ciioii^h to 
arouse antagonism) is a natural t-ondition. It has taken a 
great deal of thought on my part to try to know each in- 
dividual. 

In listening to the nurses of the different groups who have 
Tisited us ou their way home, it has seemed to me that the 
one stumbling block has been that the individual could not 
forget herself for the good of the whole. Is this disinclina- 
tion toward united effort a weakness especially of our pro- 
fession, or just a natural human in.stiiu-t? Shall we depend 
on a few strong leaders to control the number or should the 
individual he educated to appreciate more fully her personal 
responsibility? 

With a record of only five deaths among 2050 cases treated 
Ithough they had received largely only lightly wounded 
pitients), the American Red Cross Hospital No. is dosed its 
<ioors September 18, 1915. Sister Lyda with several nursea 
rt*turned immediately to tho United States. At the re<|uc8t of 
the tJermuu Goveriiineut, Dr. Snoddy with two surgeons and 
nine nurses of Unit K, as well as additional American l^od 
Crott personnel frum Buduj)ost, Gleiwitz and KoscI, went to 
Petrograd to care for Gernuin prisoners in Russia. Sister 
Lyd« described with considerable amusoraent incidents of their 
departure which were in sliarp contrast to the cordiality of the 
JBOpption given the unit upon its arrival one year before; 

Of the thoroughness of any system instituted by the Ger- 
man Uovernment. there ean he no question left in the minds 
of travelers who have crossed her bitrder the List few weeks. 
The only thing one can tltink of which they might but didn't 
do, was to apply the X-ray! 

Your clothes are removed and every garment is examined, 
for was not a woman just the day before, who had conie in 
with a presumably broken arm, found witli papers concealed 



172 HISTORY OF AMERICAN RED CROSS NURSING 



in her bttudages? Your body is examined, for in the week 
past a womnn was found with her back tattooed, showing the 
plan of the army. The soles of your feet are scraped; tliert? is 
the possibility of papers being plastered there by adhesive. 
Your tottth paste is squeezed out of the tube, your candy pieces 
are broken, your powder boxes are emptied. You feel when 
you are through, that your very soul had been ransacked, that 
they know your innermost thouj^hts. All papers, books, 
printed and written matter are held over for more careful 
reading and are mailed to you later if you leave the money 
for postage. If you remain in any German city longer than 
18 necessary to change trains, 3'ou are required to report to 
the police department when yon arrive and when yoii leave, 
giving a short sketch of your life each time, assuring them 
of your legitimate business and leaving your linger priJil. 
Any war souvenir such as bullets or anytliing used in the field 
by the soldier, maps or diaries^ they retain, giving you the 
promise that they will be sent you after the war. For the 
civilian they have no regard; he is a trouble to them in tbeii^ 
serious business of war." ^M 

In the rich plain of Hungary on the main rail and water 
routes froni western Europe to the Balkans, lies Budapest. 
Near the beautiful Vares Leget in this city, Unit E of the 
American R<*d Cross Relief mission established Military Re- 
serve-i<pi(al No. 4 of 200-bed capacity, in a modem brick and 
concrete structure which had shortly before been built as aaAl 
aayium for the blind. ^^ 

As with the otlier units of the Red Cross Ship scattered in 
the several corners of Europe, so with this group of surgeons 
and nurses at Budapest did the geographical location and the 
attitude with which the military authorities regarded the 
Americans, entirely determine the number and condition of the 
wounded assigned to the strangers' care. Budapest l>oasted 
fifty military hospitals, which gave a ratio of one soldier pa- 
tient to every eleven civilians. As the city was sp]endi<lly 
located, from a strategic point of view, on the Danube River, 
the wounded came from many points, first from the Serbian 
frontiers, then from the Western trenches and later from the 
Carpathian nnd Italian hattle-heighta. Unit E considered itself 
fortunate indeed tu he assigned to the Hungarian capital, which | 
war had made a center of hospitals. 

On October 31. fourteen days after the arrival of the unit. 

* PupfT read Ity I^yda AnderaoD before the American R««l Crou Annual 

MeoUng, 1015. 



THE MERCY SHIP 



173 



I 



Dr. Cbftrles MacDonuld, of Salem, New Jersey, director. an»l 
Sister Alice Beatle, of Cleveland, Ohio, 8Uper\'i8t)r, opened the 
doors of the American Red Crt»fis Hospital. TLe tirst assijpi- 
ment of patients was made up of soldiers desperately wounded 
daring the Austrian drive on Belgrude. It is si^ifieant of tlu^ 
Dputrality of the Red Cross that its units should hind up the 
wounds of bf»th Hungary and Serbia in the capitals of these 
aonntrioB that were iightiug each other. Within ten days, 
it F. had re<*eived i:5r> stretcher cases. Sister Katriua Hcrt^er 
!rib<Mi the eimdition in whieii the patients arrived : 

Serbs, Albanians, Himgarians, Croatians, Austrians, Monte- 
negrinB and KusKians began their long journey from the I'roiit 
on rtretehers, ox-earts and hay wagons to the nearest rail- 
road, where hospital trains brought them filthy, hungry, ex- 
hausted to us. Many of them had their faces blown away; 
pu» flowed down their chests and on tho beautiful new Red 
Cross blankets. As they arrived with Uieir first dressings 
still on their wounds tifter fifteen days' travel, it was ahnost 
impossible to protect the beds. We dressed many cases three 
jLod four times a day. 

Hideous mutilation was the rule, not the exception. It 
was a frightful thing to take off fniil dressings and see below 
the shattered, yellow flesh, the labored inspiration and ex- 
piration of the exposed lung. The thought of what pain these 
men were suffering used to sicken me. 

iron Armin Popper, General Staff, was military com- 
mander of the Red Cross Hospital at Budapest. Many former 
American citizens residing in the city opened their houses to 
the members of Unit E. Countess Sigray, the daughter of 
•us Ihiiy, of New York, and Countess Zichy, formerly Miss 

ihel Wright of Boston, took a keen interest in their com- 
patriots' work. Countess Szechenyi, uee Gladys Vauderhilt, 
pre9<?nt»*d Unit E with a beautifully complete X-ray apparatus. 
l)r. Ilertzog, military commander of the Budapest hospitals, 
often made rounds with his staff at No. 4. Professor Julius 
DuUiiiger invited the surgeons and Sister Alice to attend his 
famous clinics. 

Between the lines of Sister Alice's small leather diary ap- 
peared a brief story of the tirst month's work: 

October 30, 1914 — Supplies arriving all day were listed and 
put in place. Many gifts from peasants received. 



174 HISTORY OF AMERICAN RED CROSS XURSINi 

October 31 — Hospital turned over to American Red Cross by 

Ilerr Oherstahsarzi Hertzog; forty-two wounded 

Boldierfi arrived. 
November 4 — Xiirttes dressetl cases until 2 A. M,; two leg 

amputnlioiie. ArcbduHiorfs eiilled again. 
November 10 — Twelve patients fruni (Julicia» badly frozen. 

heavy work, 
November 11 — Nurses had cholera vaccine. 
November 13 — Twenty-two wounded from Serbian Bordei 

141 patients in all. 
November 84 — Professors from University visited ns. 
November 25 — ForlrCv^s Przeniv/J in Poland ha.>* fallen I 
November 28^Twplve jmtiont.-i ailmitted; 172 in liospital. 
November 2i) — Mrs. (Jcrard from Herlin visited us. 
December 1 — Eighteen Budapest hospitals quarantined 

cause of t^'phus. 

The work proved absorbingly interesting. Sister Alice wrote 
of the ditfercnt nationalities which sifted through the American^! 
Hospital : fl| 

Moravians, Slovaks, Dnlnmiianfl, Magj'ars, Germans, Ruth- 
enian^, Poles, Houmaniani^, Italians, C'roatians, iielvctians, 
Turks, Serbs and Russians come to us, and somehow we man- 
age to Hud out their wants and make them comfortable. Quite 
frequently we tind a man who speaks English. A few days 
ago I said to a new arrival : *'And so you speak English, ds^^ 
yow'r "Well, jus' torabks Miss." ^ 

The Hungarians take excellent care of all wounded they 
receive and arc very clever at iniprovitiing hospitals in school- 
houses, theaters, the Stock Kxrhange, art galleries, ware- 
houses, private homes, clubs and sub-stations of banks. The 
women do a tremendous amount of work here, of a type 
never essayed before. The wives and children of soldiera 
must be cared for; places niusi be provided for the blind and 
crippled whofie asylunitu are now being used for hospitals, and 
cmploynicnt must be found for tlioui^auds. This requires 
genuine organizing ability. j^| 

The longer I ptay la-re the more deeply am I impresseo^^ 
with the fact that the women who undertake foreign service 
for the American Keil Cross must be fine women before they 
are good nurses. Their work does not count for nearly as 
much as does their general bearing and conduct, both in and 
out of the hospital. 

Although the members of the Budapeat Unit were far 
moved from National Headquarters they were in an excellent 




THE MERCY SHIP 



175 



I 



to receive wisps of information regarding the other 
Red Cross personnel. Sister Ljda from nearby 
Wicn WTOto of the intcrestiug work accitniplishod at Ghnwitz 
and Kofld. Si8t<*r Helen Seott Hay, writing from Kief, aa- 
lured Sister Alice that the Russian soldiers were quite the uieest 
pitacEiita she had ever seen, A New York ne^vspaper woman 
mn^t tragic word of Serbia. Political jealousy^ intrigue 
awl cTinning ran high in the Hungarian capital. *'Sniall won- 
der,'' wrote Sister Aliee, "tliat they term Budapest the whirl- 
pool of modern Europe.^' During the early spring of 11)15, 
tbr city became a maelstrom throngh which gray hordes streamed 
down to the Carpathian and Italian frontiers. Sister Alice 
VTotc on March 11 to Miss Delano: 

You have read in the papers about the movement of Ger- 
man troops to (Jnlicia. Serbia and Transylvania? Thosie mil- 
liong of men keep mnrching past our hospital. \ve<'k in and 
week out. Troop trains constantly go by night and day, 
loaded with soldiers and anmiiiiiition. Army wagons, ara- 
bobnceB, artillery, automobiles, ox-carts and aeroplanes form 
m never-ending procession. All types of vehicles from an 
imperial coup6 to a Fifth Avenue motor bus are used. 

Tbe l^icrninn s«jldiers are always singing. At almost any 
hour of the night when one awakens, we cnn liear "Die Wat'ht 
am Rhein" or ''Morgenrolh." As tliey swing past our lius- 
pital in the daytime the infantry smartly salute the Stars 
and Stripes above their heads. 

Hot summer months brought no cessation of work to IFnit E. 
Sifter Alice's letters referred repeatedly to the unselfish hclp- 
of the wounded. When it became evident tiiat he could 
►ver, a critically ill soldier was removed in July to a 
hospital nearer his home. His comrade in the next bod, who 
hftd helped care for him constantly, came to Sister Alice the 
next day and asked if his cot might not be placed by the iiido 
of iome other very sick patient. "Die Sch western have taught 
W0 bow to be gentle/* be said, ''and I would help.'' 

When the American flag and the Red Cross banner were 
iovercd for the last time, Septemlxjr 20, 191.0, the Red Cross 
hoepital closed its doora with a record of 1543 cases and 313 
ttajor operations. The death rate was less than one and one- 
half per cent of the total admissions. Dr. OookMt(»ii, Dr. Met- 
edf and Ur. Miller, with eleven nurses, joined Dr. Snoddy's 
nut for service among German prisoners. 




176 HISTORY OF AMERICAN RED CROSS NURSING 



WboTi the American Red Crass had offered its ten relief 
units in August, 1914, to the belligerents of the European War, 
the detachment of twelve nurses and three surgeons destined 
for duty in Serbia, had not Imxmi sent upon rlie S. S. Red Cross, 
because of the expense thnt wruild have attached to an extended 
trip of the vessel down through the Mediterranean for just these 
fifteen. Thus a dingy merchant vessel instead of the white 
Mercy Ship brought Unit No. 1 to Saloniki for its destination 
further north, at the time the first overwhelming tide of suffer- 
ing and disease incident to the Serbs' gallant part in the war 
rushed across the sunny agricultural lands of the little Balkan 
principality. 

The Serbian people had always been a nation of farmer- 
soldiers. Pride in ownership of field and cattle-herd had bred 
a fierce national love of independence. Manual toil, shared 
alike by rich and poor, had developed a fine, upstanding democ- 
racy. The people had clung desperately through years of in- 
ternal and extenial warfare to the hope of a great Jugo-Slavic 
kingdom. Since the dawn of European history, the Balkan 
peninsula had constituted the natural trade-gates to the East 
and its control had been the goal of ambitious world-powers 
since the days of ^Vloxandcr the Great. Exhausted by two 
previous wars, Serbia chose to submit to the terms of Austria's 
ultimatum of July 23, 1014, rather than to endure her power- 
ful neighlvtr's "punitive expedition." But in spite of Serbia's 
humble agreement to eight of the ten Austrian demands, Aus- 
tria declared war ^Tuly 2S on the seemingly defenseless little 
kingdom to the south. History records the resultant action of 
Russia, Germany, France, Great Britain, Italy and the United 
States. 

Serbia swiftly mobilized her five million population. An 
heroic baud of 000 medical men marched away with tlie new 
Army. Serbia had only one doctor for every 5500 of her sturdy 
p'asant-soldiers. The gi>vrrnment immediately accepted the 
offers of sanitary assistance which were extended her by the 
Red Cross societies of several then neutral nations. 

Among these contingents of surgeons and nurses was the 
American Red Cross Serbian Unit No, 1, of which Dr. Edward 
W. Ryan, of Scranton, Pennsylvania, was director and Mary 
E. Gladwin was supervising nurse. Miss Gladwin's share 
in Red Cross nursing in the Spanish- American War has already 
been mentioned. She was graduated from the Boston City 



THE MERCY SfflP 



177 




I 



I 



. was in turn superintendent of nurses of the Womaifs 
, New York City; of the City Hospital, Cleveland, 
Ohio; and of the Akron (Ohio) Visiting Nurses' Association. 
At a Japanese base hospital during the Russo-Japanese War, 
Ant had received experience in the lonely, monotonous, ex- 
hugting school of war nursing. As chief nurse, she htid (li- 
the relief work of many American Hed Cross nurses 
ng the Dai,*ton flood. 
Upon the arrival of Unit No. 1 at Niah, Crown Prince Alex- 
♦T uaked the Americans if they were williug U) reptirt to 
the Military Hospital at lielgrade. The Austrians were at 
that lime bombarding the city. Unit No. 1 accepted tlio chal- 
lenge with alacrity and on October 15, 1914, took over tliis 
cxeellently equipped institution, then tilled with wounded Serbs. 
The Military Hospital at Belgrade consisted of nine modern 
Mone pavilions, erecte<l in 11)07 by the military authorities. 
The main building had two wings in which were two large 
operating-rooms, a lalK)ratory, a main office and four wards 
of fifty beds each constnicted according to modem standards 
«ath white-tiled floors and ample windows. Adjacent to the 
building were medical and surgical pavilions of one 
Inindred Lfdi* each. Nearby were the administration building, 
the kit^'hen, laundry, chapel and morgue. A magazine and 
trenches plainly visible from the windows of one pavilion 
brought home to the Americans their closeness to war. 

Grave difficulties confronted this unit of three American 
surgeons and twelve nurses. During the first seventeen days 
of heroic house cleaniug, they cared for approximately one 
thousand lightly wounded Serbs, Dr. Ryan's responsibilities 
were greatly increased by his appointment on November 25 to 
the general directorship of the military and civil hoHpitals in 
the entire city. His and Miss Gladwin's professional and ad- 
ministrative duties were further complicated by the fact that 
they could communicate with National Headquarters, Wash- 
ington, I). C, only through the already overtaxed cables of 
the 8tate Department. Medical supplies could not be obtained 
IB Belgrade, Food for the patients was unsuitable and inade- 
te. Overhead shrieked the Austrian shells. Miss Gladwin 
ibed the bombardment of the city : 



oute 
daicri 



There was no time during the first six months that Borae 
of the guns were not fired. My room was a little white-washed 



178 HISTORY OF AMERICAN RED CROSS NURSING 

one. Every time one of the bi;j French guns would fire, for 
example, it would show the flash on my wall. It would 
illuminate the wall and then, in a second or two, I would 
hear the boom of the guns. That kept up night after night.'** 

At two o'clock on the morning of November 30, the Serbian 
authorities notified I>r. Ryan that they were evacuating Bel- 
grade heeause their supply of ammunition was almost exhausted. 
They left one hundred of their seriously wounded in hia care. 
Of the taking of the city, Dr. Ryan wrote Major Patterson : 

No uutlioritics were left. As there were many robbers about, 
stores were looted. . . . Many people were being held up in 
broad (inyh'ght and it was neces»J«ry to do something for the 
poor who had no food. As we had not enough for the patients 
at tlie hospitals, I sent men into the country to bring in all 
the food they could lay their hands \i[Km. l^iit before their 
return the Austrians arrived and forty-eight hours after the 
first troops, their wounded. 

We worked day and night until we could no longer con- 
tinue. We had wounded men everywhere. Starting at six 
oY'lo(.'k in the morning we would dress wounds all day. About 
nine oVlock at niglit we would start to operate and work 
until five or six in the morning. Many nights we got no 
fileej* and never more than throe hours. Halls, floors of wards 
and every plate a man could (it in, we had filled. We had in 
tliis hoHpital for several days thri'i^ tliou.'^iuid wounded and 
one day we had nine thousand in the grounds. I was then 
forced to tieg the Austrian otticials to send some of them to 
the hospitals in Iluugary. 

During the Austrian occupation, the American Red Cross 
furnished food, eoul and wood to all the hospitals in Belgrade 
and supplied six thousand loaves of bread daily for the poor. 
Soup, a little meat, a few beans, and an allowance of two 
hundred and fifty grams of bread, comprised the rations for 
patients and staff of the Militar}* Hospital. 

An instipportable burden of work confronted the nurses. The 
Austrians brought hundreds of cases of frozen hands and feet, 
dysenterv*, recurrent fever, typhus and typhoid to the American 
Rod Cross Hospital. Other patients suffered from every type 
of rifle, shrapnel, grenade and bomb wound. Ox-carts and hay 

*' Paper read by Mine Gladwin Iw'fore the Nincti'tnth Annual Cunvpntion 
of the American XursM* AMOciation ht>ld bt Now OrK^antt, Ln.. 1010; 
l«t^r pulili^hrtl in the Amvrieon Journal of hurnng, June, 1010, VoK XVI^ 
page 1)05. 




THE MERCY SmP 



179 



ms had tnuiBported some of the patients, often without 
eren First Aid dresaings on their wounds, from remote monn- 
tain towns. Ganpreue set in and the exhausted nnrses, on their 
slow roundis to ininister to tlioae who posHessod at least a lighting 
rhanee for life, had t-o pass by the doomed men. Miss Gladwin 
wrote of the pitiful cries of the dying: 

There was a ward next to mine, with a door leading directly 
into it. I could hear every sound in it and I used to tumble 
into bed at two or three o'clock in the morning nnd hoar 
thosie men in the ward. They begged and praj'ed in all 
languages for help. They swore, they tore their bandages 
AJid the nights when I got up (it took all my strength of 
mind to stay in bed), I knew exactly what I woulrl find when 
I went in, — the men in their apony tearing off the dressings, 
the dark streams of blood on the floor. *^ 

In the meantime the Serbs had received a fresh supply of 
ammunition from the French. They rallied and advanced on 
the too-contidcnt Austrians with a fury which drove them com- 
plrtcly out of Serbia. The order to evacuate Belgrade came as 
quirklv to the Austrians as to the Serbs. Cannon began to 
thunder afar during the early dawn of I>ecember 13. At eleven 
o'clock, Serbian and French heavy artillery had found the range 
and were pounding the slopes of the city. Dr. Ryan wrote: 

By one o'clock, the battle was raging on the outskirts. 
At dark, shells were bursting everywhere. The streets were 
jammed with cannon, ^Idierd, supply wagons and horses 
going toward the bridges that wou!*l take them across the 
Danube and Save rivers to safely. They continued the 
retreat until the next morning, when the Serbians destroyed 
the bridges, leaving those who had not gotten across, as pris- 
oners on this side. About five hundred Austrian wounded 
▼ere left in our care. 

The following days brought lighter work to the hig military 
hospital. The earc of the Serbian wounded was not so heavy- 
"The work has been indescribably liard," wrote Miss Gladwin 
ilisB Delano, "hut it has grown much litchtor during the last 
•kfl. The nurses arc becoming a little rested, in readi- 
the Next Thing, whatever that may be.'* 
ife Next Thing was t^>'phu3. Hordes of refugees pouring 

"Paper read by Mistt Glndwin before the Nincttvnlli AnnuftI Convfntion 
of lli«» Amtrirjin Xurscs' AKMKintifm liekl nt New Orlenns. La., 1016; 
later published in the American Journal of Suriting, Juuc. 1016, Vol. XVly 




180 HISTORY OF AMERICAN RED CROSS NURSING 

down from the frontiers, a shortage of adequate food and Uic 
total dearth of Serbian doctors and nurses favored the con- 
tagion until it swept the little principality. A graduate of 
Roosevelt Hospital, then in Nish, wired National Headquar- 
ters; "Typhus raging throughout country. Mortality high. 
Cholera feurrU later. Help urgently needed, especially doctors, 
nurses with hospital isolation equipment, distnfectors for 
t^V-phus clothing." Mr. Bicknell, National Director of the 
American Red Cross, then in Europe with the Rockefeller Com- 
mission, cabled : "Typhus overshadows everything else." Dr. 
Ryan's report for February gave fuller details: 

During the month we added to our nximber about 800 
patients, totaling 1850 in all. Typhus has overrun Serbia. 
In Xish alone there are one hundred deaths a day and I 
believe at least fifty a day here* though Belgrade is better 
off from a amitary standpoint, than any city in Serbia. 
Typhoid claims its share. Many die also from, relapsing 
fever. There are always shells pasning over us, as the Aus- 
triaus retaliate on Belgrade tlie French lire on the City of 
Semlin across the river, now exceedingly high. This pre- 
cludes the possibility of military action for some time to 
come. Fortunately it will give us a chance to try to get rid 
of the typhus upon us. 

Until April, 1015, at the height of the typhus epidemic. 
Unit 1 had worked entirely alone as the only group of American 
siirgoons and nurses in northern Serbia, hut circumstances out- 
lined Iwlow then drew to them members of two olhi*r American 
Ilcd Cross units which bad previously been assigned to duty on 
the southern frontier at Gevgeli. During the autumn of 1914, 
following the suwress of Unit No. 1, the Serbian Government 
had requested National Red Cross Head<]uarters to send addi- 
tional surgecms and nurses to assist them in earing for their 
sick and wounded. In response^ two units had been sent to 
Serbia in Deceml)er, 1014, and had been assigned to a large 
military hospital iumI prisoulsmip at Gevgeli, fifty miles inland 
from the Gri»ek l)order. Dr. Ethan Flagg Butler, of Washing- 
ton, I). C, was director of Serbian Unit No. 2; Dr. Ernest 
Pendleton Mngmder, of the same city, was director of Serbian 
Unit No. 3 ; Mathilde Krneger, of Detroit. Michigan, was super- 
visor of the twelve nurses who compriflod the nursing staff of the 
two units. A detailed account of their struggles at Gevgeli 
will follow. 



THE MERCY SHIP 



ISl 



Wbile Dr. Ryan and his associates were endeavoring to 
dieck the spread of the typhus epidemic in Belgrade, word 
came during the hi8t dayd of Februnrv, 1015, to the American 
consul at Nish that the majority of the members of Units Ko. 
2 and 3 had been infected with typhus at Gevgeli. He im- 
mediately communicated with Dr. Ryan and with National 
Red Cross Headquarters. Major Patterson cabled Dr. Kirby- 
Smith at Pan to send one surgeon and throe nurses of ^le 
French units to the aid of the stricken Americans, and in- 
rtmcted Dr. Ryan to investigate inmie^iately the situation at 
Gevgeli. Upon his arrival there, Dr. Ryan found that only 
four nurses of the staff of twelve and two doctors of the original 
Dumber of aix had escaped infection. These six Americans 
still on duty were, however, taking good care of their own sick. 
Dr. Ryan suggested that Units 2 and 3 withdraw from Gevgeli 
to Sflloniki as sofju as the health of tlie patients permitted. He 
then on March 3 returned to Belgrade and resumed his efforts to 
c»mbut the typhus which was becoming epidemic in Bel^ade, 

For the next three weeks, Dr. Ryan was the only American 
surgeon in the big Military Hospital. His two assistants had 
returned to the United States, March 3, in company with three 
nurses of Unit No. 1 whose strength hud not been equal to the 
strain of the Austrian twcupation. The depleted unit tried gal- 
lantly to meet its responsibilities. "Life is rather monotonous/' 
Miss Gladwin wrote Miss Delano, "we go nowhere and see few 
people, but we get along surprisingly wclL I am as usual 
well," she continued, "a little thin pt^rhaps and acquiring gray 
hairs steadily, but happy and content to be in Serbia and glad 
to have escaped the fuss, feathers and festivities which seem to 
have overtaken some of our units." 

In the meantime, Dr. Kirby-Sraith and llie nurses from Pau 
bad arrived at Saloniki and there had found several i-ouvales- 
cent members of Serbian Units No. 2 and 3. Leaving the 
ttarsefl there, he had then gone on to Gevgeli and found tliat 
the patients were progressing well there and that the remaining 
members of Units No. 2 and 3 would be able within u few days 
to withdraw entirely from that ill-fated Serbian hospital camp. 
He and Dr. Bntlcr then proceeded to P»elp'ade to consult Dr. 

S^ an regarditig the next mr)V(\ They arrived at the Military 
spital ou tlie very day that Dr. Ryan himself came down 
with typhus. Miss Gladwin wrote of her emotions when she 
fint aaw them : 



i 



1 



182 HISTORY OF AMERICAN RED CROSS XURSIXO^ 

I went back to the sterilizing-room and as I entered l^^ 
looked up. There in the doorway stood two men in the un^H 
forms of American Red Cross surgeons. I rubbed my eyes]^" 
bocauBe I thought that my wish for help was making me see 
visions, but I went forward and found Dr. Kirby-Smith and 
Dr. Butler. It seemed the merest accident which had brought 
them there, but I sliall always believe it was in answer to 
prayer. 

The contagion swiftly overtook other members of the unit 
at Belgrade. On March 28, Hiss Gladwin wrote Miss Dolanc* 
that Ida Lusk, a BelicvuG niirse, was desperately sick with 
typhus. Dr. Ryan had develop4'd pjieumonia. *'It is pitiful," 
^liss Gladwin added, **tn hear him in his delirium going ov 
and over again the details of the wi>rk." 

Immediately upon his arrival, l)r, Kirby-Smith wired to Dr. 
Magruder at Saloniki for which recnforcements from Units 2 
and 3 as might safely be spared. Then with Dr. Butler, he set 
to work. In that over-cruwded hospital shelled by enemy fire, 
with an exhausted nursing stuff and a stricken director, Miss 
Gladwin and the remaining seven nurses faced the rounds of 
duty with cheerfulness and ei|uauimity. Fear held tlieir hearts 
in a grip of iron, hut tlie diflcipline of their pnifession steadied 
them and sent them ahnut their duties, which was soon to in- 
olndo the care of other desperately ill nurses and the burial 
of one of their ]x»st-loved surgeons. VVitli the eahnness of the 
experienced sanitarian, Dr. Kirby-Smith reported to his su- 
perior officer at National Headquarters: 

The typhus situation : At the time of my arrival* the 
epidemic was at its height, with nine hundred cases under 
treatnjcnt in the typhus pavilions. The*^e buildings were not 
under our administration. Our own wards were overcrowded, 
and patients had necessarily been admitted in such large num- 
bers that there was no chance to give them careful examina- 
tion. The result was that typhus became epidemic in our 
pavilions, Kyan probalily contracted the liisease hy working 
in the wards. This nuiy also be said of Miss Lusk, although 
she had specialed several cases. 

Dr. Magruder arrived in Belgrade March .11. He had fevec^^ 
of lot degrees withiit a few hours, in fact he had not beed^H 
well for ec\eral days prior to leaving (Jcvgeli. but nntwith^^™ 
standing this, he continued his work of arranging transpor- 
tation for his party and supplies, working hard at a time 




THE MERCY SHIP 



183 



when he should have been in bed. During the first days of 
his illne$6» bis condition did not give us undue alumi, but 
thirty-six hours before his death, he was suddenly over- 
whelmed by poisons of the disease. He died April 8 and will 
be buried here in the Civil Cemetery. 

Miss Helen Kerrigan, of Brooklyn, New York, was taken 
suddenly ill April 13. Typhus was positively diagnosed a few 
<hiTfl later. She evidently contrat'ted the disease from work 
in tlie wards. 

XiAd Helen Smith became ill April 18. She had specialed 
Miss Lusk and had not been on <luty in the wards for a 
month. 

Miss Rebecca Watson (from Pau) developed severe typhus 
May 5. 

Tiie nurses have been moved to a part of the hospital enpe- 
cially cleaned and disinfected for their occupancy. Only 
oit-aHional cai^es now develoi) iu our wards, and it is believed 
Uiat wp will soon have the disease entirely stamped out of our 
pavjliuns. Of course, there remains the chance thnt our 
jiersonnel may be bitten by an infected louse, conditions being 
such that we have not entire control over every one with whom 
we come in contact. 

The routine of the hospital now runs smoothly. Dr. Butler 
with Dr. Downer as his assistant is in charge of the surgical 
pavilions, and the enclosed list of operations gives an idea of 
tht* work being accomplished [averaging five dailyj, Drs. 
Kirkpatrick uud Hagler each have a large pavilion. My 
duties are largely administrative, but I have given my per- 
sonal attention to the members of our party stricken with 
lyphtjs. Dr. Kyau is making a good convalescence, and I 
hope aoou to turn over to him the management of his hos- 
pital. I will at once start for home^ with Miss Lehiiianii 
And Miss Ixjfving [May 0, 1015]. 



While the routine work of saving life and warding off death 
to ihft last moment of resistance, went on as usual within the 
Atncricfln Hospital, spring came to Belgrade with soft winds 
and vivid sunsets. Clear balmy days brought out the eon- 
Talcsccnta in wheclH?hairs to watch the French aviators circling 
the city on their way to and from scouting expeditions across 
the Danube and the Save. Though the enemy made ready to 

low his assault, all Serbia drew a vast sigh of relief and 
the summer with h<tpe. Typhus was gone, thanks largely 

that band of forty-seven sanitarians under Dr. Richard P. 
Strong, which the Rockefeller Foundation and the American 



184 HISTORY OF AMERICAN RED CROSS NURSING 



Red Gross had sent during the dark days of early spring," 
And no loiiger did the menace of cholera fill man, woman and 
child with paralyzing fear. 

Upon the arrival, April 13, of six relief nurses and two 
surgeons, better days came qnifkly. Following their convales- 
cence, Mis» Smith and Miss Kerrigan were transferred to an 
American Red Cross hospital at Yvetot^ France. When tired 
monilMTs from all thnv iiiiitH were invalided home in June, 
Miss Dc'lauo scut otlicis ti> till ihc gaps. Miss Gladwiu*8 letter 
of July 7 to MisH Deluiui diiTered greatly from those short 
notes written in previous mouths: , 

You are cordially invited to a t^a at the American Hos-- 
pital at fonr-thirty o'clock. You will have no dirticulty in 
finding us, as our flag on the clock tower is visible from many 
partfl of the city. The sentry at the gate will let you through 
the archway. Come along the drive under the tower. As 
you open the front door leading into the hig. cool hall, you 
will see Old Glory again, colorful and splendid against all 
our whiteness, giving you a sense of proto<'tion and security. 

Come straight down the corridor to double-doors opened 
wide in welcome. A great, white-tiled rrxmi. with enormous 
window spaces; a long writing-table covered with green blot- 
ters ; a newspaper tabic ; and a tea-table ^ay with bright chintz, 
a bunch of blue and white larkspur, another of purple ten- 
weeks stock, red and white geraniums in pots and begonias 
covered with coral blossoms, — that's our tea-room where you 
may find on any afternoon a warm welcome and many cups of 
Sir Thomas Lipton's "best." 

You will like the Red Cross family. You know all my 
girls, hilt you haven*t seen them in their gray gowns as they 
come from their work in the wards. You will like the way 
they look, a little tired and worn, perhaps, hut eontented and 
happy, women who huve made a name for good behavior and 
hard work surh as belongs to no other mission in Serbia. 

You may not know the men so well. Though he may be 
called away Iwfore his second cup is poured, our Director will 
come. The Secoud-iu-Command will drink his tea with great 
enjoyment. The Profejisor will bear in his hands a potted 
geranium which he carries from room to room seeking sunny 
windows. Kumor hath it that he sings a lullaby to it every 
night ! 

The Photographer with his big pipe in the comer of his 

" For an account of the work of tbia commiMJon Bee *'Under the R«d 
Cross Flag/' Mabel T. Boardroan, J. I). Lippincott Company, 1016, 



THE MERCY SHIP 



185 



mouth ami his bauds ilripping "hypo/' will hurry across from 
tlie dark room to eliow you his latest picture of the market- 
place. Come see our Student, our Atheist, our Democrat aud 
our Boy for yourself! 

Delay in thr loiig-f xpocted advance of the Russians and Serbs 
upon Bndaportt lightened materially the work at the American 
Hospital dnring the smimier, but tried the nerves of officers 
and privates alike. 

During the hot summer months, the immaculate hospital on 
the hill maintained an average of six hundred patients. Quiet 
days brought the x\mericans welcome opportunity to become bet- 
ter acquainted with their simple-hearted, generous, appreciative 
•oldier charges. One sister wrote of her orderly; 

The linen closet on my floor was not clean enough to suit 
me. After 1 had sijent an entire afternoon on it, one of the 
"bolachi" (as they call the men who help us), came into the 
ward clapping hid hands and beckoning me to follow. I did 
so, thinking that he had seen the linen closet and approved. 
When we both got to the door, he clapped his hands even more 
delightedly and motioned me to open it. To my astonishment 
out flew two white pigeon**. He had arranged a cozy nest fur 
tliem among my immaculate sheets! At intervals he would 
come and get me to go with him to see his pets Hy out and 
light on his head. When they were banished^ he seemed al- 
moet heart-broken. 

Evcr>' lime an Austrian bullet is removed from a Serbian's 
wound all the patients get around his bed and sing the 
Serbian national anthem. I had a boy of seventeen who had 
had a bullet removed from his foot. On his return from 
the o|)eraling-room he was still half under the anaesthetic 
and 1 left him for a few minutes to get a hy]X)dermic. I 
returned to tind him sitting up in bed, completely surrounded 
by other patients, all who«)ping lustily ! 



The second Austrian offensive, long expected by the French 
and Serbian armies, was launched against lielgrade in Septem- 
ber, 1015, The American Red Cross Hospital quickly tilled 
with wounded. Although the American Ked Cross f(»nnally re- 
called their foreign units on October 1, 1915, the Serbian 
lister of War, in the name of their King, begged the Ameri- 
to remain, assuring them thut the Serbian Government 
vould gladly defray expenses. Bulgaria was on the verge of 



186 HISTORY OF AMERICAN RED CROSS NURSINi 



a declaration of war. One hundred and twenty thousand Oer- 
man troops were massed ar-ross the River Save. Dr. Downer 
described how the Austrians captured the city: 

From our vantaj^e jwint we could witnesB every move in the 
desperate uudertaking. Tlie broad river lay beneath us and 
to the right rose the Kalenegdan, the old Belgrade fortress, 
with its white tower and it(^ white walle, datiug from the days 
when the Turks were masters of the city. Just across the 
river the comhinod Au^tro- Hungarian and liermau lieavy 
artiHory were hurling their great projectiles, searching for the 
Allies' artillery position?. Allied artillery wore dropping 
shell in Semlin. trying vainly to reach the guns that were 
slowly battering down tlicir own defenses. The Austriaiis' 
thirty-jK)iut-five mortars were throwing entire houses into the 
air, leaving great craters fifteen feet deep and thirty feet in 
circumference. Added to this, the city caught fire and at 
night was a most wonderful sight. 

In this wild scene we cotitd see tliin battalions of Hun- 
garians, lying with their feet still in the river on the Bel- 
grade side of the streanu hold in check by a murderous rifle 
and machine gun tire from the old wiills of the Kalenegdan 
and the trenches along the Danube; the damaged pontoons 
full of dead men floating <lown stream with the swift cur- 
rent; the (Germans making tiieir blo4Kly struggle to cross over 
the (lypsie Island and finally tJ»e combined Austro-dcrrnan 
rupli from the river to the trenches and the fearfid hand-to- 
hund fighting with bayonets, knives and club-guns. -^J 

After that came the street fighting, the rally of the Serb^^ 
from Porlock Heights back into Belgrade, in which heavy 
infantry and artillery figliting raged around the gates of 
our hospital all night, until finally in the morning tlie Serbs 
retreated for good. And then we heard the distant booming 
of the cannon at Avile, showing that the Serbs were resisting 
to the last the terrible onrusli of the Austro-German forces. ^^h 

Under that symbol of mercy which they had worn so well, 
Serbian Units 1, 2, and 3 could not at this hour desert the 
crowded hospital. They remained at their posts of duty when 
the dusty, gray hordes again swarmed the streets and they 
kept tlie doors of the Military Hospital open alike Xo Austrian, 
Bulgarian and Serbian wounded. After six weeks of stress, 
they turned over the management of the hospital to the Aus- 



""The Thriw<'flpturrd 
<Vr>ji« UtiffaxiHe, 1910, Vol. 



Cnpital." 



Dr. 

78. 



Earl B. Downetj AmcrioanBgd 




THE MERCY SHIP 



187 



trian inilitarj authorities and entrained November 28, 1915, 
for Vienna. From Vienna, in groups of three uiid four, the 
Bnrgeons and nurses went their several ways homeward to 
merited rest. 

On ihe single railroad which in 1014 eiit directly north and 

ith across Serbia, lay the isolated dejwt of Gevgeli. In tliia 
dreary town near the Greek frontier, American Red Cross 
Units No. 2 and 3 established and attempted to maintain a 
uitlitary hospital under conditions which made their brief stay 
a disastrous yet heroic incident of American Kcd Cross service 
dnring tlie first year of the European War, 

During the last weeks of Deceml>er, 1914, American Red 
Gross Units No, 2 and 3 arrive<l in Salonlki and wen* nssigued 
by the Serbian Government to the .Military Base Hospital and 
Prison Camp whi<'h had Ikx'U opened iu Gevgeli to supplement 
the already overcrowded hospitals scattered throughout the 
crntral part of the small principality. Dr. Ethan Flagg Butler, 
of Wa8hingt4jn, D. C, was director of Unit No. -; Dn Ernest 
Pendleton Magrudcr of the same city, was in charge of Unit 
Xo. 3; Mathild Krucger, of Detroit, Alichigau, was supervisor 
oi the twelve nurses. 

So highly developed were the medical departments of the 
armies of the Allied and Central Powers at the outbreak of 
hoetilities, that sanitary conditions existing in the Balkans 
red at first unWievable to the pioneer surgeons and nurses 
%ho went there in 1D14. Native standards of livings primitive 
to a difrree astounding to Americans, were lowered by the lack 
of Uxtd and other supplies of every description, by tht* short- 
age of lalntr and by the alisence of a native medical and nursing 
personnel. 

F.mily I-ouise Simmonds, a graduate of the Roosevelt SchiKil 
of Nursing, New York City, who underUH)k service under the 
fierbian Red Cross, wrote of her iinpressioiis of three military 
bpspitals in Serbia during the winter of ltH4: 

Oevgefi is the first Serbian town acrotis the Greek frontier ; 
it really represeuts a station depot and a cigarette factory 
of four stories, surrounded by a eommunit}' of squalid little 
hots. 

At Kraguyevftts [northern Serbia), T went for a walk one 

ffpnifK)!! wlioti I fitiw a dressing-room orderly emptying waste 

eanj*. fillod with Ihe pu.s dressings, in a ditch opposite the 

main building. He answered my question by stating in a 



188 HISTORY OF AMERICAN RED CROSS NURSING 



surprised voice that thoy had never burned them and it seemed 

uniiec'essary to nUrt now. ^H 

Of 2500 Austrian prisoners at Uskub, 1000 are dead, 20^| 
are on their feet and the rest are down with wounds and 
typhus. Here their liospitals are in long, low-roofed barns 
vilh two-fot)t windows on one side ouly. Beds are often 
pushed together so that three men lie on two cots, with 200^, 
in eaoh barn, dying at the rate of forty a day. 'fll 

One of their biiihlings was on a steep hill and the orderly 
used to empty the dressing-enns over the wal! where they 
wouhi blow about in (ill directions. The Turks (llskub was 
Turkish two years ago) used to pick these over, taking the 
cleanest ones to line their wadtleej waisteoats. 1 don't want 
to Im? disgusting, but 1 do want to make you appreciate that 
this may be the beginning of an epidemic and is an instance 
of whnt is happening all over the country. If any help is 
coming it must come at once and must bo of drastic measure. 



The American Red Cross Units Nos. 2 and 3 were placed ia 
charge of an improvised hospital located in the cigarette factory 
described by Miss Simmouds. It was without heat, water, or 
drainage and it sheltered under its leaking roof 1200 surgical 
patients. Two days after the arrival of the units, 560 addi- 
tional wounded raised the quota to well over 1700 sick and 
dying men. Hospital e<|uipment consisted of straw mattresses 
laid 4in the tobacco-littered lioor. Every drop of water had to 
be brought from a distane(\ All waste and excreta were carried 
to a cesspiMil 8c;v(*ral hundred rods from the building. The 
basement was tilled with an accnnmlation of soiled clothes 
and linen over which thousands of body lice crawled. When 
Saints' Days did not forbid, three Turkish women came to wash 
a few sheets and pajamas in small crib-shaped tubs similar to 
American chopping-V>owl8. 

Gevgeli was a small community. Serbian officers occupied 
the few wretched lodging-houses. Quarters in private houses 
could not be secured. The nurses liad to be assigned to a native 
hotel in rooms approximately twelve feet square, without light or 
heat, — three women to a r(^H>m. The bods consisted of straw 
mattresses mounted on woo<lcn frames. One small tin basin 
and a water jug were the ouly toilet a<'commodation8 furnished 
the twelve nurs<»8. The doctors were <iunrtered nearby at the 
cholera Imrracka. Their meals, ciK»kcd in the general hospital 
kitchen and served iu the stall dining room^ were adequate^ 






THE MERCY SHIP 



189 



fjtcept perhaps the traditional Serbian breakfast which cou- 
MBti'd of tea with lemon and toasted black bread. 

Miss Krueger stated the spirit in which the American units 
sUrlcd to work: 

In this unsanitary location, the building crowde<l to its 
doors, with vermin and filth on ever}' hand and no pruspeets 
of obtaining vitally needed equipment for firomoting better 
sanitary conditions, we went to work, nut upttnnt^tin nor 
sanguine of results, but with a determination to do our 
best. . . . 

A staff of two hundreil nurses would have been inadequate. 
For four days we spent our entire time getting all seriously 
wounded into one ward, averaging four liundnMl drcs.«ings a 
day. Badly infected wounds were the rule, not the exception. 
Many had not been dressed since tompornr)' First Aid on the 
field ten days to two weeks previous. Every day we realized 
more and more how pitifully inadequate was our force. Con- 
ditions grew more disheartening with each week." 



I 



The tobacco factory was so dirty that the American surgeons 
did not dare attempt there the heavy surgical work impera- 
lire for the recovery of the patients. Dr. Butler accordingly 
secured, January 1, li>15, a large tobacco shed for use as a 
temporary surgical hospital. At the coat of much time and 
disoourngi-^ment, the Serbian Government finally furnished a 
anal] amount of equipment, including windows, a most imptirt- 
■Dt item. On the day of the first operation, January 13, the 
American flag was bravely hoisted over this warehouse. A 
sifling process of seeking out operative eases in the tobacco 
factory and of scrubbing, shaving and clothing them before 
transportation to the warehouse for operation, soon filled the 
•o-called ''American Hospital" to over-capacity. Miss Krueger 
continued : 

Most tragic of all was the meager and unsuitable food 
supply. Two meals a day consisting of veg»?tRble soup and 
coarse browu bread was the allowance for all patients. They 
were fed on this diet and then treated for dysentery, typhoid 
and other intestinal diseaHCS witli a wisdom equal to tliat of 
the sage who dipped up water iu a sieve. Poesibly some notes 

"Paptr prepared by Mim Krueger for the convention of the American 
K urtr A««ociation. 1015, at San FrnnciHCo, Calif.; later publiahed In 
iU Awt^riMn Joumct of Nurting, Vol. XV. p. 1014 1015. 



190 HISTORY OF AMERICAN RED CROSS NURSING 



taken from my diar^' give a better picture of things as llit 
were: 

January 7— All the wards of the tobacco factory very cold 
patients suffering; food very scarce; impossible to g« 
milk or eggs. No dean clothes for the patients or bedi 
no laundry done for four day.s, being holiday week. 

Nurses all have bad colds and begin to show Btrain 
work, which is fatiguing, depressing and <iishoartening« 
I insist on tbeir having one afternoon and half Sunday 
to get out in the air and sunshine. 

January 20 — New cases of typhus, pneumonia and i^mallpa] 
developing daily. Four hundred cases of recurrent feveri 
many of theni among Austrian prisoners who have be< 
our only helpers. Sanitary conditions indescribable. 

January 28— -iledical wards almost hopeless, so many dospei 
ately sick patients, very little food and no orderlies to 
help with the work. One ofiour doctors and two Ameri- 
can nurses oil duty with temperatures 103 degrees; prob- 
ably typhus." ^ 

The fight at Gcvgeli had begun against overwhelming odds.^^ 
On their arrival Units Nos. 2 and 8 had found the sick and 
wounded in so pitiful a condition that eonunon humanity had 
prompted the Americana to assume charge immediately, with- 
out taking the time necessary to render their own living con- 
ditions at least reasonably safe. Massed against them were la< 
of equipment and supplies, overwork, a strange language aii4 
that pf>tent ally of typhus^ the body louse. 

The members of Units Nos. 2 and 3 went down one by oi 
before the fever. Dr. Lane was unable to report for dutj 
January 28; Clara Tulloss, January 29; Clara blusher. Jam 
ary 30; and Dr. King, February 7. Anna Lockerby wrol 
MissiDelano: 

'On Monday. Febniary 8j Miss Krueger did not feel well, 
^but WBson duty all day until four o'clock. Two hours later 
her temperature was \0'2 degrees. Wednesday, there was no 
doubt that she had pneumonia. Wilhelniina NVeyhing did not 
feel well yesterday. February IS : today she had a temperature 
of 104 degrees ;'ty]ihus, of course. 

We are very much crippled in our work. Dr. Butler says 
we must come firi^t. Our dressings are holding out. Wiat 
we need most is milk, rocoa, rice, eg^s and any kind of other 

"Paper propHn-il by Mihh Kriu*p<T for ihr conv(*ntion of tlip American 
Xur»cH* Aniswiatinn. lUl'i. nt San Fruncit^eu. Calif.: later publiohad m 



4li9 Amerimn Joumai o/ Auifflriy, VoL XV, ji. lOl.i-iOUI. 




tHE MERCY S] 

food. All diet we give our patients is cabbage soup. Sir 
Thomas Liptoii and his nurt^en stopped to aee uh on their way 
to Niflb aiul left us such food an he could spare from his 8liip. 
Dr. Butler has worked hard to get a plaee at last where we 
cau have our cook and buy our own rations. 

Teresa Curley was the next member of the units to become 
infected. On February 18, Dr. James F* Donnelly, of New 
York City, came down with it; the following day, Maude 
Ellis; ihe following day, Mary Sichrs; on February 21, Mary 
D. Cox. The next day Miaa Knioger developed typhus fol- 
lowing pneumonia. Of the original eighteen comprising the 
nnitfi, four miraea and two doctors remained oa duty. Miss 
Lockerby wrote Miss Delano: 

In two rooms we have three nurses each and across the 
hall, two others, all typhus, some cages three weeks old and 
one eleven days. Misnes Fry, Tetrault and 1 care for them; 
Miss (*anfiehl is nursing Drs. King and Lane during the day. 
Drs. Magrudcr and Butler have done evorytliing in their 

iwer to help. When the crises oame, they wanted to stay up 
II night so we four couhl nleep. 

There have been so many things besides the sick nurses. 
I was the second person in Dr. Donnelly's room and helped 
the doctors. None of the nurses know of his death yet. That 
was a very hart! day. Something 1ms come up concerning 

Dr. whicli required a firm stand from the director. 

The nurses were quite excited at first. 1 said they must obey 
or go home and tfiey remeuiberud what you hud siiid in New 
York to Miss Krueger. 1 felt sure that in her ilUiess you 

would want me to make the same stand. Dr. has 

left the unit. 

February was a dark time for all Serbia. "We have ourselves 
lost one hundred and five doctors," cabled the Serbian Red 
Crofls to iVmcrican National Red Cross Headquarters. Four 
of the British Red Cross Unit died at Uaknh. Two surgeons 
and three nurses of the linssiiin Red Cross BuccumbtHl at Nish. 
S*j tragic were the h)S3c8 in the Dutch and Gnvk <'ontingcnt3 
that these units were withdrawn from the country.'** Sir 
Thonnis Lipton, who had brought over the British Red Cross 
units on his yacht Erin, said in cable dispatches: "One can 

American Hed Cram Hagaaine, VoL X, p. 180. 



192 HISTORY OF AMERICAN RED CROSS NURSING 



scarcely imagine the terrible ravages of typhus, far worse than 
typhoid and even the Black Plague/' Only with difficulty waa 
Serbia able to bury her dead. ■■ 

Drastic measures were imperative. Wlien Dr. Ryan came^^ 
dowii from Belgrade, a consultation was held between the 
American surgiHins and two doctors of the Serbian Red Cross 
and it was decided to withdraw L'nits Xos. 2 and 3 fro m, ^ 
Gevgcli to Saloniki, GrciMv;, as rapidly as the condition uf tli^H 
sick would pcnnit, for n^cuperation and ret>rganization. Dr. 
Kirby-Sniitli, with three nurses from the French units, were 
on their way to Saluniki from Pan. lie and his party, in- 
cluding Dr. George W. Mellon, of Beaver, Pennsylvania, wh o ,-, 
volunteered his servicres when he heard on shipboard of thdfll 
desperate need, reached Salrmiki on March 18 and found Dr. 
Butler and several convalescent members of Units Nos. 2 and 
3 in a third-class hotel, the only one in tiie Greek seaport which 
would receive the infected Americans. Leaving the tliree nurses 
there, Dr. Kirby-Smith went with Dr. Butler to Gevgeli where 
Dr. Wagruder was taking care of the remaining members of 
the two units. Miss Lockerby's report of March 19, to Miss 
Delano told of conditions at Gevgeli: ^M 

I am so happy I am almost afraid to write. All of our 
eick were able to sit at table for dinner. I Loidd hardly keep 
the tears hack, — I felt burf this day would never couiu. Seven 
of our convalescents are in Saloniki. Dr. Kirby-Smith came 
down today leaving his three nurses with them there. 

Now the days grow warmer and tlie quaint native women 
come out in their bright drenses to gossip as they stand knit- 
ting by the roadside, clicking their tongues as fast as their 
needles. . . . 

This week we were able to do a little hospital work. I gave 
chloroform for twenty-one operations. SomelimeH th Ik meant 
that 1 didn't get to Miss Krueger, whom I am caring for, 
until live oVIoek. She is very anxious for us to get back on 
duty. 

Major Patterson cabled Dr. Xirby-Smith to consolidate the 
units, as the health of the individual members permitted, at 
Belgrade. Gradually strength returned to the eight convales- 
cent nurses and to Dr. King and Dr. Lane at Saloniki, enabling 
them to return early in April to the Unite<i States. 

On March 25, Dr. Kirhy-JSmith and Dr. Butler had gone 




THE MERCY SHIP 



193 



to Belgrade to interview Dr. Ryan about bringing the unin- 
fected mirs4^^'s and doctors to Belgrade. After wiring Dr. Ma- 
pruder to bring up what reenfon-ements he could spare, they 
reuiained at the Military Hospital to take care of Serbian 
Unit No. 1. Dr. Magruder with the three '^surviving" nurses 
reported at Belgrade, March 31. "At last our wishes have come 
true and what is left of Units Nos. 2 and ^3 are here!" wrote 
Ifias Lockerby. Tlieir joy was short-lived. On Ai)ril 18, she 
wrote again: "All our time since January has been a strain, 
but it seemed almost more than we could endure to have to 
Iniry Dr. Magruder. Yoti will never know how much he 
helped us," she continued, *iic was sick In^fore we left Gevgeli, 
hut he wouldn't give up, nor at Saloniki. He died after five 
days' illness here and was buried in the Civil Cemetery." 

Here ends the separate history of Serbian Units Nos. 2 and 
3u Subsequently they shared the experiences of the Americana 
■t the Military Hospital in Belgrade. 

Just as the subsequent history of the three Serbian units 
Sierged into one, m has the record of individual experiences, 
^l&ftsded t*^gcther in the archives at National Headquarters, been 
merged into an awesome whole. The terse cable messages, the 
fltiort letters written in fear and exhaustion whitrh recount the 
fortunes of the gallant units at Gcvgi^li and Belgrade, picture 
,ir»r surgery and war nursing with terrible reality. Filth, 

inototiy, hunger, pi'ril, agony, dishonor and despair were 
then*; ao also were courage and faithfulness unto death. Let 
the fact that human strength faltered once or twice show the 
intense^ strain nf those days! For one man who left his post 
«f dnty at an hour of need, there were eight surgeons for whom 
pertilpuce held no terror. For one nurse demoralized by utter 
cdiauBtion, there were twenty-two others bravo and strong and 
moe under the lingering shadows of death, Florence Nightin- 
IDikr'B experiences at nearby Scutari were not more difficult 
tiun those of these lied Cross nurses. 

In far Gevgeli, a white stone cross marks the ivy-covered 
piTe of an American surgeon, Dr. James F. Donnelly. In 
s- 'it burial-ground in Belgrade, where black marble shafts 
|- .vard among dark cedars, another Kcd Cross physician, 

I^r. Kmest P. Magruder, rested quietly until cessation of hos- 
tihties permitted the return of his body to his native soil. 
Daring the happy days before the war, youing Dr. Magruder 
Ittd gone to Scotland to ascertain whetlier he was a descendant 



194 HISTORY OF MIERICAN RED CROSS NURSING 



I 



> 



of the famous MacQregor Clan. There he lind met nnd ma 
ried the daughter of Lord MacGregor of Edciichip, V^alquhido 
A letter written by his widow from her father'H home during 
the first days of her loss bears testimony to the spirit of saeri- 
lice with which the Red Cross moves forward: 

Realizing as I do huw immense are the elaims on the funds 
of the Aniericnn Red Cross, I have already written Miss 
Boardman to aeknowledge my Hpprei'iatiou of the ai-tiou of 
your committee in making an allowance to me and my little 
son. I hope it will ondhk" nic to keep my small boy with me. 

It is my great consolation to know that my husband laid 
down his life in the service of others, T feel I should like to 
express to you tlie adniiration. — the deep admiration, — I 
have as a Britisher for the noble spirit that actuates t' 
American Red Cross. 

In these days when all Europe is in anxiety and mournin;^ 
and when a dreadful spirit of hate hns raised its head sIkjyc 
our boasted eivilization, one sees in the selfless devotion of 
Americans, in no way hound to share our suffering, a ray of 
real comfort and ho[>e and a glory far greater than any wol&fl 
upon the battlefield. '^^ 

Here ends the experiences of the units which had sailed 
upon the Mercy Ship for service in European theaters of war. 
Three other units were assigned, however, by National Head- 
quarters during the winter of 1014-11)15; one of them went to 
Yvetot, France* and the other two to La Panne, Belgium, A 
brief account of tlieir experiences belongs in this chapter which 
summarizes the service of the American Red Cross to the 
Central and Allied Powers before the entrance of the United 
States into the World War. 

The first year of the war had been marked by the estab- 
lishment of many hospitals under organizations of varying; types 
and aims. Throtighout the first six months, wounded had come 
bsck from the Marue and from Ypres in increasing hordes. 
The existinj^ capacities of the sanitary scrvicH's of the Allied 
Powers had been greatly overtaxed by the influx of patients, and 
their development retarded by shortage of supplies, pt^rsonnel 
and transportation facilities. By serving on committees in- 
trre,st<'d in the establishment of auxilinrv hospitals and con- 
valescent homes and by contributing lavishly to tlie support of 
such institutions, men and women in every station of life, both I 
in England and in the United States, seized avidly the oppor- 




THE MERCY SmP 



19A 




tunity for dissipating their own emotional tension and for 
geuuiiielv aiding the wounded soldier. 

Al Yvetutj France, ou the Kiver Seine, within easy reach of 
Honeu, oiie of the principal piilitary bases, th*^ French Gov- 
prnment piaced at the disposal of the Committee of I'FIojntal 

I'AUiant.e Fotulalion AiifjUiint' vf Ainenrnnw a lurgt* njon- 
S(*hoo] for l>oya, *eft vacant eight years before by the 
vparation of Church and State, — this structure to house a niili- 
Ufv hospital for the care of British, French and Belgian 
•oidiera. The hospital was supported by volunteer contribu- 
tions from industrial workers in Great Britain and America. 
The aim of the committee, wliose chairnuni was Dr. F. S, 
m, Bishopsgate, E. C, was to afford other industrial 
ips, particularly those engaged in the manufacture of gov- 
ernment supplies and munitions of war, an opportunity to give 
"their bit" for something tangilile. Backed by the influential 
London committee and by many Americans of wealth, the 
koBpital was in a splendid position to secure equipment and 
personnel. It was later ranked second to the American Am- 
bulauce at Paris, conceded to be an ideal institution of its type. 

Dr. Ralph Fiteh, a Bostoniaii, was director of the Alliance 
Hospital. He had practiced his profession in Rochester, New 
York, and was an orthopedic aurgeou of brilliant powers. Be- 
fore sailing for France in December, 11H4, where both he and 
hia wife gave prodigally of their wealth aiul servici's, Dr. Fitch 
bad n^uested nursing assistance of the American Bed Cross, 
iliould the need l)e great enough to justify the expenditnre. 
After hia report of conditions existing at Rouen, France, Na- 
tional Headquarters confirmed his appiintineiit as a Red Cross 
■nrgeon, in order that lied (*ross nurses might he assigned to 
the Alliance Hospital, and dispateliod on the Rochamhenu Feb-4 
roary 2'»i^ 1015, a unit of nine nurses, with Alary M. Fletcher, 
of Charlottesvillo, Virginia, as supi'rvisor. 

Upon rheir arrival at Yvetot, Ahirch 2, 1915, the American 
mmes found a well-equipped institution with chapel, admin- 
WlTtttion building, bacteriological laboratories and six large 
virda of fifty beds each. A separate wing of the building 
(ttataining one hundred and eighty beds, which was operated 
by the FVeneh Ived Cross, brought the total capacity of the 
luj((pilnl to five huiidred. A convalescent home ac^commodat- 
b^ beti^'een thirty and forty patients was maintained al nearby 
VfoUie-lea-Roees. i • r i n i t 



196 HISTORY OF AMERICAN RED CROSS NURSING 



Alliance Hospital was governed by a Board of Administra- 
tion consisting of the chief medical officer. Dr. Dudley 
D'Avergne Wright, of London ; Dr. R. R. Fitch, Captain 
T. J. C. Warren, of New Zealand, and Mr. George S. Taylor 
A9 businesa manager. Two English surgeons and two students 
or "dresst^rs" completed the medical staff. Sixteen English 
Sisters including Matron Adelaide A. Wood and ten proba- 
tions, with the ten Americans, composed the nursing staff. 
Eighteen inferyniers^ French soldiers unfit for duty at the 
front, served their military term there under a Fi'ench Ad- 
jutant. To supplement these orderlies, six young English 
and American men acted as strcttiher bearers and ambulance 
drivers and did genera! rejiair work. To volunteers from Great 
Britain and the United States was delegated much of the 
routine hospital detail such as the care of the laundry, the 
kitchen, linen rtMjnia and the vesfinire. Barou Itothsehild's 
chef was triajor dumo in the kitchens. 

During the first weeks, the nurses at the Alliance Hospital 
experienced the same innctivity which taxed the cheerfulness 
of the American units at Paignton and Piui^ hut as the winter 
of 1915 dragged on, the Americans gradually won the con- 
fidence of the English and French authorities, so that the care 
of large numbers of patients was entrusted to them. Two of 
the American nurses were placed in cliarf^e of one of the wards. 
A third was appointed night superintendent, acting in Alatron'a 
place when she was absent in England for several weeks. "We 
have tried very hard indeed," wrote Miss Fletcher, *'io remem- 
ber not to spill our efficiency over onto the aprons of the Eng- 
lish sisters and probationers," 

The work at the Alliance Hospital was almost entirely sur- 
gical. Many bone cases required plating, and all wounds had 
to be drained freely. After a winter in the trenches, with 
nerves pounded thread-bare by shelling and *'wind'' shortened 
by continual cigarette smoking, the soldiers were in poor condi- 
tion for long general anaesthesia. Uenct* the cartes drajq^ed 
out while the surgeons waited for wounds tt) heal before at- 
tempting second nnd third operations. Mary K. Nelson, in 
ciiarge of Dr. Fit.ch*R operating-room, descriljed tJie patients 
arriving from Ypres as wretchedly wounded, their mud-soaked 
uniforms a torturing, exhaustive burden. 

The American nurses found a certain deep satisfaction in 
caring for cases which they received from hoBpitals further 



THE MERCY SHIP 



197 



the line. In writing to the Princeton Chapter, which paid 
the salaries of several of the Pau and Yvetot nurses, Miss 
Fletcher said: 

To get cases which have beoit unavoidably neglectec! in an 
ovcrcrowHod hospital for from two clays to two months, may 
seem uninteresting and perhaps not quite fair from a pro- 
fessional point of view. It does, however, present a wonder- 
fully humanitarian opportunity to give them stientific' surgical 
ctre. Since it is not onr country which is at war, we cannot 
all expect to be at the front. 

The English Tommiesi are munhing through under my 
window, with an unending procession of lorries, transjKirts 
and yellow-brown ambulances, on their way to Amiens and 
Nismes. 

About every ten days splendid young, fresh men go through 
on machine guns from Havre straight for the front. They 
are usually about forty at a time and are called the Sundry 
Brigade. They are all sure of dentil. When they stay over 
night at Yvetot. the hospital bus an impromptu concert. Any 
one whom the others think can sing eveu a bit is sent up lo 
perform. You always feel that the^e boys who can cheerfully 
undertake to entertain this company must have nerve enough 
to do anything? They are always given cotfee and cakes and 
are so appreciative and cheerful it makes jour heart ache. 
You know almost all of thum will go down. 

One of our patieut?i. a man of thirty, has lost both arms. 
Yesterday his wife, who hnil not Hcnn him for months, came 
into the ward. His face was heart-breaking to look at. He 
tried so hard to keep the tears back, but tliey would come and 
she bad to wipe them away. 



August, 1015, brought many changes to the Allianco Hos- 
pit*L Of tlie ten nurses, one felt it necessary to return to 
the United States. Later Miss Fletcher turned over her bu- 
perrwory duties to Miss Nelson. 

**B©inenibering what you said about the one thing yon would 
inflist on, — *no foolishness'," wrote Miss Fletcher to Miss De- 
kikOy *^t is pretty hard for a supervising nurse to have to con- 
fers she is engaged." 

"Sever your connection with your unit at once," answered 
Mias Delano; "under present conditions, there is no room in 
the Red Cross for service and romance at the same time." 

Accompanying this official message, however, went a personal 



198 HISTORY OF AMERICAN RED CROSS NURSING 

letter: "I am delighted to hear of your cngagemeut, my dear," 
•wrote Miss Delano, "and hope most sincerely that he is worthy 
of you and will make you happy." 

To fill the two vacancies caused by Miss Fletcher's resigna- 
tion and the return of the other nurse to America, Sisters 
Smith and Kerripui were transfernHl to Yvetot from Belgrade 
after tiieir recovery from typhus. The greatest cJiange came, 
however, on August 15, liU5, when the French Goverunicnt 
requestitl Dr. Fiteh and the American nurses to take charge 
of Military Hospital No. 45 bis, at St. Valery-en-Caux, a little 
Norman tishiug towni on the Channel, between Dieppe and 
Le Havre, 

The nurses at once fell to work house-cleaning their new 
hospital. Strenuous days and nifjhts followed. Only two of 
the nur8e3 \v*'re itulcpeudciit of their salaries; eight of thoui, 
however, decided to rrmain on at St. Valery-en-Caux without 
remunerutitin after the lied Cross had recalled its foreign units 
on October 1. Miss Delano cabled that the nurses might retain 
their Red Cross eiiuipment. Miss Nela^u acknowledged this 
gift and in the same letter described how beavy their work had 
become : 

With our conHtnnt influx of seriously wounded men directly 
from tl)e front, it wu? almost impoHsihIo for us here in this 
little village on the coast t^» ohtain uniforms and aprons 
immediately. Over nt home such a supply is a simple matter, 
but here it is very different. You will appreciate that our 
entire thought, time and energ}' has been given to the work 
itself, to the care of the wounded and the management of 
the hospitAl. 

It is now long past midnight and common sense reminds 
me that at least six hours of sleep are necessary. We all seem 
to have grown acciistoiued very easily to longer hours of duty. 
At last we have the work we noped to find! 

During the autunm, 1915, Miss Nelson built up a strong 
nursing statT nt St. Valerv-en-Caux. To supplement the eight 
from Vvetot, shv seeun^d three 'Vasual*' American nurses, two 
?!nglish s'sttrs and nine partially-trained women. The capacity 
of riJoftiffil AtwUlnrv No, 43 was then raised from sixty-five 
to one hnndrf*d and sixty-one l>ed8. Besides directing the 
nursing statf, Miss Nclsim had rliarge of the operating-nx)m. 
The surgical department had been greatly strengthened by the 




THE MERCY SHIP 199 

<rf a pi^table X-rtj plant. wiA an electric graerik* 
tor, froiiL die Frmch Serriet de Samite With Uie incr««»ecl 
mwTfcg sCrcaigtiL and with tfaid excellent ei|iupment, Vh. Fitcii^s 
kMi{»tal reeeived a montblv average of one hundred and tifty 
pataenta^ In a Ie«er vritten October 2<>, to Miss IX^lams Misa 
Nekon told of the preasare under which thev worked : 

I scrubbed up sbortlr after three P. M. and had my gloves 
off onlT about half an hour for a bite of dinner in the sterilii* 
ing-room about eight that evening. It was four-thirtv the 
next morning before we finished, only to begin again that after- 
noon. As ever so many of our grands ble^es are bad joint 
wounds, the work in the wards does not lighten. 

The nurses have borne up remarkably well under the strain. 
Dr. Fitch is very considerate. He planned no operations to- 
day and placed his big car at our disposal. The four night 
nurses went driving this morning and six others will get the 
air the rest of this afternoon. 

Until we have more nurses, it seems unwise to take more 
patients or to open our convalescent hospital of thirty beds 
at Veuille-les-Roses. We need it though, for it is hard to 
start these boys away to other hospitals for their convahwonco 
just when they begin to pull up. Such wounds as I hnvo 
never seen before and I thought Td seen horrible oncH, — 
shattered hips, knees and shoulders all calling for export 
nursing care. 

Whenever there came a lull in military oporatioiiB Vllopital 
Auxiliare No, 43 his drew patients from the Hurroundln^ 
country, or nursed the saddened Belgian n'fug(!e children in 
nearby orphanages. Three of the American nurHCs returned 
to the States during the spring but Miss Nelson, Helen Kerri- 
gan, Josephine Clay, Helen Spaulding and Marion M. Riee 
remained. 

Here, during the summer of 1010, ended tlie letters iind 
records which tell of the events of the Yvetot Unit. The little 
hospital at St. Valery-en-C'aux continued to render ycouKui 
service during the crucial winter of liM'J-l!*17. Xearby Amierm 
was the Headquarters of the British Kxpcditionarv Fon-cH. 
The enemy was massing his strengtli againnt V'Tduri, while 
the Allies hung breathless on the outcome of that savage as- 
Mult. Pounded by every type of artillery fir**, shattered by 
shrapnel, mowed by machine (runs. [ioiv>n-tr;i- und Fhimmfii 
verfer, France during these months was liolding the heiglitit 



200 raSTORY OF AMERICAN RED CROSS NURSING 



of Verdun at a total cost of 550,000 casualties among her 
picked soldiery, some of whom lay iinburied among the craters 
on tlie shell-plowed slopes, while others came straggling back 
through casualty clearing stations to the French and Allied 
bases. How gallant a part the American staff of VHopiiaL 
Auxiliare No. 43 bis played in later Red Cross endeavor will 
be found in a subsequent chapter. 

Wlien tlxo American Red Cross had first offered its medical 
and inirsing units to Europe following the deirlaration of war, 
Belgium had asked only fur mippliea. The Belgian Red Cross 
mobilized with Albert's Army, but no sanitary organization 
could cope with the woimded which flooded back to the coast 
towns of the Channel and the North Sea. By February, 1915, 
Albert with his forty thousand Belgians held a strip of land 
forty miles long and ten miles wide from the Yser to Holland. 
Directly in the path of the Taubes, at La Panne, Belgium, 
the Belgian Red Cross was reorganized and from this uncon- 
quered territory on February 21, came their appeal to the 
American Red Cross: 

We need about twenty or thirtj' nurses, four or five sur- 
geons, one thousand beds complete with sheets, covers and 
rubber sheeting, tents for housing one thousand beds; tents 
for pernonnel and large quantities of surgical dressings, 
tetanus serum. 

(signed) DePaqe. 

Antoine DePage, a surgeon of Brussels, and Lieutenant- 
General Melis, Inspector General of the Health Service of the 
Belgian Army, headed a committee appointed by King Albert 
to organize Belgian Red Cross field hospitals. While Dr. 
DePage was building the pavilions of Vflupital de VOcean on 
the sand-hills four miles above Nieuport, Madame Marie De- 
Page, his wife, made a flying tour of the principal cities of 
the United States to raist* funds to support tliis medical city of 
twelve hundred beds. Tn response to her solicitation, the 
AmericaTi Red Cross plt'dged itself to support two units, of 
three 8urgfH»nfl and twelve Red Cnjss nurses each, at La Panne, 
as it had done in 1014: for England, France, Russia, Germany, 
Austria and Serbia. National Headquarters also donated two 
complete fiel<l hospitals and $20,000 for their maintenance. On 
April 17, 1015, Belgian Units Nos, 1 and 2 sailed on the 
S. S. St, Louis for Liverpool. Dr. Albert R. Goodman had 



THE MERCY SHIP 



201 



I 



been appointed senior director of the two uniu, but was 
obliged in London to return to the United State's and Dr. Uol»ert 
Hinds, of Buffalo, succeeded liim there, Dorothy M. Ferree, 
of the Hejiry Street Settlement, Xew York City, and of Phipps 
Institute, Philadelphia, was general supervisor of the twenty- 
four nurses. 

Under the shadows of war, the Belgian units were delayed 
three weeks iu London. Already VHopiUil de VOcean was 
being shelled and it was deemed unsafe to send additional 
personnel there. Dr. DePagc came over to England in May to 
confiilt with the director of the Belgian miita and to welcome 
his wife on her expected return from the United States with 
drafts for $100,000 which ^^he had raised for Belgium's soldiers. 
Her eagerness to reach La Panne had made her disregard 
Germany's warning to the paascngera scheduled to sail on the 
Luaii-ania on her last fatal trip. The giant liner was sunk 
and the body of Marie DePage was rt»eovered and was brought 
in to her husband on the docks. Pa,>-mcnt of the lost drafts 
was cancelled and the fruits of her labors were later sent 
over by a more forttmate courier, but the American nurses 
in London were not soon to forget that earnest, intelligent, 
eager little woman who had waved good-by to them in New 
Yorit with her smiling farewell: "I am here so that you can bo 
there." 

Dt. DePage brought his wife's body to La Panne on May 
20. The Belgian Units Nos. 1 and 2 had left I-ondnn the 
day before for the beach-hospital. From Dieppe to Nieuport- 
lee-Bains, they foxind themselves veritably in the war zone. 
At Forges-les-Eaux, where they 8p<;nt a night at a hospital 
which sheltered three hundred wrjunded, they found hotels, 
busses and trains operated entirely by women and convalescent 
nldiers. Calais was in total darkness. A Frenchman guided 
them with a small pocket flashlight to motors which curried 
duftn to a school-house; there they 8j>ent the night on inm 
hflopital oots which now filled every avuiluMe building. Miss 
Ferree described the £fty-mile ride iu ambulances to La Panne, 
Hay 19: 

The roads are well guarded everywhere; thirteen sentries 
stopped us to see our pa6f:ports. At noon we drove straight 
through the ruins of Dunkirk. 

La Panne has one long street into which run several 
smaller ones. The houses appear to have been set down care- 



202 HISTORY OF AMERICAN RED CROSS XURSIXG 



lessly in the sand. The beach and sea are beautiful, but all 
else i« desolate among the ruins of shelled villas. 

The streets swarm with soldiers in from the trenches. 
The population seems to have swolleu overnight from two 
thousand to ten thousand. Here too, all lights are put out at 
night and curtains tightly drawn. 

Marie DePage was buried among the sun-blcacbed dunes of 
the shining beaeh near I'llopiial de I'Ucean. Botwcon double 
lines of soldiers moved the flower-covered casket, followed by 
American, British and Belgian nurses. Dr. DcPage, accom- 
panied by his two sons, who had come in from the tn^nchea 
for their mother's funeral, marched with oiRccrs, Belgian 
nobility and foreign medical units to the lonely grave, then 
returned with resolute countenance to carry on the work for 
whicli his wife had given her full, joyous life. The first year 
of the war did not allow Belgium's citizens the luxury and 
comfort of prolonged grief, — there was too much to be done. 

As viewed from the sea, Vllopital de VOcean rose high 
above the white sands on the sloping beach. A summer hotel 
had been converted into the main building. Four large tem- 
porary pavilions, lightly eonstnicted of wood, with corrugated 
in>n rtKifs on which huge Bed ('rosses had been painted, had 
been erooted around it to form the wards. Snrgeona and nurses 
were quartered in sumnuT villas, taken over by Dr. I)t*Puge, 
**The hospital is very comjilcte," wrote Dr. Ilinils, the tlireclnr 
of the two KiMJ (■rosa units, to Major Patterson, "it has two 
steam laundries, a bacteriological lalxirutory, a small steam 
sterilizer, and an instrument-maker who manufactures from 
steel strips excellent operating-knives and even nickels them 
afterwurds." A uewly-instalicd bath system of twenty-four tubs 
bathed live hundred soldiers a day who came in relays from tho 
front. One regiment was always quartered at La Panne; 
■fter scrubbing up, tho men received clean underclothing Vnd 
their uniforms were de-loiised and mended. • 

Miss Winch, an English nurse of tact and executive ability^ 
'WW Matron of the hospital. Her staff consisted of well over 
one hundred and fifty French, English, Belgian, Canadian^ 
American, Danish and Swiss nurses, speaking many different 
languages, and trained under different customs. The hours 
of duty were from 8 A.M. t^i 8 P.M., with two hours off, be- 
sides ample time for meals and four o'clock tea. 

La Panne lav in the coveted road to Calais which commanded 




THE MERCY SHIP 



203 



t 



I 



I 

I 



itrol of the Cliamiel beyond. Three lines of defense 
led their harlvd wire entanglements and sand bulwarks 
botww^n VUdjriiai tie VOcean and the enemy. No one could 
wholly nnderatand during the summer of 1915 just exactly 
why the Gmnana did not blow the hospital-eity entirely off 
the ahcll-craterod beach. Some said the enemy would not 
harm Elizabeth of Belgium, whose days were spent among the 
wounded. 

It was quite a formal occasion when the Queen of the Bel- 
giant visited the pavilions. Xnrses and all patients whose 
«tn-npth permitted, remained standing while Elizabeth dis- 
tributed chocolate and cigarettes. Dr. DePage carried *'the 
smokes" and Miss Ferree the candy. A lady-in-waiting always 
followed the Queen from ward to ward. Dix, a sparrow which 
one of the Iwys had brought from Dixmnde, had little under- 
standing of court etiquette. It perched first on Miss Ferree'a 
stitfly-starched Red Cross cap and persisted in remaining there 
until ahe shook it off. It flew to Dr. DePage''8 head, then back 
to its vantage ground alH)ve Mias Ferree's neatly brushed hair, 
where it sat in dignity until the general laughter of the ward 
startled it again and it flew to cling with cold thin claws to 
Queen Elizabeth^s hand. "It is remarkable how happy every 
one is here," philos<tphized Miss Ferree in her reports to Miss 
Delano, "and how soon one gets over momentary fear." 

Eleven nurses of Belgian Units ^'»is. 1 and 2 returned 
October 1, 1915, to the United States after six months' service 
at La Panne, and their places were filled by nurses whom 
Misft Delano transferred from Paignton, England, and Pan, 
France, Sister Vashti Bartlett took Miss Ferree's place as 
supervisor; Dr. W. T. Fitzsimons, of Kansas City, Missouri, 
succeeded Dr. Hind as senior director of the Belgian units. 

The Americans from Paignton and Pan found life at La 
Panne vastly more exciting than that among the Devonshire 
hills or the sunny valleys of the Pyrenees. A fragment of a 
German shell tore up the bath-room fl<x)r of the Albert and 
Elizabeth pavilion. Another killed nine and injured forty 
nrilians in the street outside. Off-shore the British fleet lay 
thundering a tremendous response to the long-range German 
gQUA. Half with pleasure and half with dread, the nursea 
watched the great white geysers flung up by enemy shells, sus- 
pestded for a moment like phantom sails drifting on the blue 
fevd of tiie water. At night they lay awake and listened to the 



204 HISTORY OF AMERICAN RED CROSS NURSING 



"coo-cj" of big Berthas singing through the air over their 
heads. Their own windo\\^ were zealously curtained and only 
a dim candle flickered in the long, silent wards. The night- 
nurses often paused to watch like summer sheet-lightning, the 
Hashes from the treneiies a few miles away. The glow of an 
oeoiisional star-shell often silhouetted a belated fisherman com- 
ing liomc across the lonely, glistening beaeii. 

Throughout the winter of 1915-1916, Taubes and Zeppelins 
releasfd their bombs on La Panne as they returned from 
raids on the Channel ports. Sunday seemed a popular day for 
bombinf^ liecause sunshine brought out the crowds on the beaches. 
The American nurses were not soon to forget the horror that 
one or two well-placed bombs made. The anti-air craft guns 
were as noisy as the Taubes, but doctors and nurses no longer 
left their busy wards to sve how many victims the bombing par- 
ties cHUSfHh Fortunately the weather often kept the air craft 
behind the 0<*rituui lines. The clinging white fog of the Flan- 
ders coast chilled the nurses' heatless rooms. The cold rains 
and harsh winds sweeping down from the North Sea sent them 
shivering about the loiisely-efmstructed pavilions. Lydia Shrope 
could not throw otf a lingering cough. When Dr. Fitzsimons 
told her that she had developed tuberculosis, she returned with 
Grace Bentley to the United States in February, lOlG, bitterly 
disappointed in having to leave the Belgian service. After 
gallant pfruggle at a private sanatorium and later at Fort 
Bayard, New Mexico, where the Red Cross had sent her, she 
died at Fort Bayard, July 14, 1918. 

L'llof/iial de rOreuii received only Belgian soldiers and 
the work was largely surgical. Sister Emogene Miles, who 
had been in charge of the operating-room at Pau, found the 
service at La Panne exactly as difficult, as splendidly worth- 
while as she had anticipated that war nursing near the front 
would be. Sixteen beds in a surgical ward which received 
only serious operative cases were assigned to her. An FngUsb 
girl acted as her aide. Three Belgian doctors were in charge 
of the ward. "They surely work hard to save these exhausted 
men," concluded Sister Emogtnie, "the work is sad and many 
die, I nevi-r l»efon* gave so many hypodermics as I do here." 
Gas gangrene with it* fetid, sweetish odor, was omnipresent. 

During the early Flanders spring, National Headquarters 
recalled Belgian Units Nos. 1 and 2, after they had completed 
a year's service at La Panne. This period of time was equal 



N 



THE MERCY SfflP 



205 




to tlttt which the units of the M eroy Ship had gpent 
to tlie other belligrrenta. The nurses of the Beli^an 
La Panne in May, VMd, Some juinetl the American 
nt Pftris; others did further war nursiug iu Kug*- 
Itnd; bat the majority returned to the Unittnl States, where 
onxsooa doods were gathering. On the Western Front, Fraucoi, 
Bdgimn and England face<l the **hloo<l bath of the Sittnnie.'* 

Between August, 1014, and May, 191(5, Miss Delano alone 
hdd in her powerful hands the strands of policy and admin- 
istration which extended like light steel wires fnun Wushiug- 
too to the fifteen supervising nurses lo(*ated in England, Hussia, 
Oermanjy Austria-Hungary, Serbia and Belgiiuu. 

NatSonaJ Headquarters of the American Red Cross was then 
located in a tliree-story red brick house on the corner of Seven- 
teenth and H Streets. The Nursing Service oeirupied two nie- 
dinm-sized rooms and a hall-way on the seetmd floor. The 
financxs of the Ked Cross did not pennit spacious otticos, nor 
hjid the beautiful memorial buildings furnished by otuitribu- 
lions from the government and from p\il)lic-8piritt*d citizens, 
been completed. Miss Delano sliared a single, kire, high- 
eeilinged room with her stenographer and her ii.ssiatant, Anna 
Reereft. A rusty leather couch stood against the wall on one 
ride; her oak desk occupied a comer. At the back of her 

ivel chair was a commonplace oak bookcase. Directly in 
t of her desk was a huge, high-baeked wicker eluiir. By 
reason of the sunlight slanting in from the windows to the left 
and behind her, Miss IX'lano held the advantage sought by 
many astute executives, of being abl(» to see every change of 

X?«siou aWnit the eyes and mouths of the nurses. Army 
rs and volunt<*ers who faced her during the innumerable 
conferences held In that busy office, 

Uiss Reeves had been detailed by the Surgeon General of 
the Army on November 17, ll»18, for duty in connection with 
th«' ' 'U of nurses fur the Kcd (Vohs Reserve. She was a 
gTi' f the Philadelphia General Hospital and had juiiied 

the Army Nnrse Corps in 1910. Upon her assignment to the 
Red Cr)S8 she assisted Miss Delano with the enrollment and 
helped to recruit and to equip the nurses for the Mercy Ship. 
Her ilfiik and the lyp<'writer tabh? Hto(»d on tin* f»ther side 
of the r(M)m. between an open tirc-place and the main door. 
Adjoining Miss Delano's office^ was the hall in which Marion 
r, of New York, worked over the much-discussed problem 



■ ride 



206 HISTORY OF AMERICAN RED CROSS NURSING 

of the mobilization of lay-women for war service. At Miss 
Boardmuu*8 retjueHt, Miss Oliver had come to National Head- 
quarters in 1915 to organize groups of nurses' aides similar 
to the Voluntary Aid Detaohments of the British Kod Cross. 
She was app*)inUKl a member of the National Committee on 
Red Cross Nursing Service in December, l'J15, and continued 
a member of Miss Delano's family until the Red Cross decided 
that the service of nurses' aides» if aueh bwame necessary in tlie 
event of war, should be directed by a Red Cross nursc\ 

The Red Cross Town and Country Nursing Service occupied 
the second room; here Miss Fannie Clement and her assistants 
held sway until the removal of this section in July, liH6, to 
the Mills Building. In a small attic room upstairs, the tiles 
of the National Committee, thou contoining the naines of six 
thousand euroUed nurses, were handled by a Washington nurse, 
Lily Kanely, of the New Haven Hospital Training School, 
who also assisted Miss Oliver in the details of examinations 
and certificates of Red Cross instruction in Elementary Hy- 
giene and Home Care of the Sick. 

Equal simplicity existed in other departments at National 
Headquarters. Miss Boardmau was the guiding spirit of the 
urgaui^atiou. Major-Genoral GtH)rge W. Davis, U. S. A*, 
retired, was chairman of the Central Committee. Mr. Ernest 
P. Bickuell, formerly of the Chicago Rureflu of Charities;, 
was national director; bis duties kept him in Europe the 
greater part of 1914-1015. In a large nx^m on the first floor 
Mujor RolxTt U. Patterson* ^ledical Corpsi^ V, S. A., detailed 
by the Surgeon General of the Army to the Red Cross^ was 
cliief of the Bureau of Meilical Service. Mr. Charles L. 
Magee was secretary of the organixation and also acted as dis- 
bursing offitHT for the treasurer, the Honorable John Skelton 
Williams. The pay-roll for the entire National Headquarters, 
including the clerical statf and a single messenger, contained 
biavly fifty namcA. 

Miss Delations odScial family numbered ten members aikd an 
efficient yet informal gn>up it was. Although she was thivtugh- 
out her Red Ctx)«8 labors a full-time vohmteer, Hias Delano 
appeared every uiomiug at nine o'clock ; often ber arms were 
full of flowvn and bright leaves for the raaes on ber detk and 
boctkoaae. Her ainifalar gradoasneas of pevaooatilj perraded 
the din^ rooma and e^-oked from ber staff an tnterest in the 
Nursing Service vhii^ pn.>mpted them to work cheerfullr after 




THE ArERCY SHIP 



207 



kdan and during holidays if ne<>d oxistod. *'When you'd 
rally seen her big heart tiiidorneath/' said one of her 
**you never noticed afterwards how imputiout she 
fDt with >X)U, or how late she asked vou to stay." She often 
bought her **live stock" to the office. On such oera^sioiis her 
•ewftary took complete charge of her parrot, bequeathed Miss 
I>eUno by her mother. Polly could not ho left alouo in the 
apartment on Biltmore Street, when her niistress was on one 
of tboee flying trips to New York, uor could Patrick, an Irish 
terrier, then on an indetinite visit to Miss Delano, tlumj^h tho 
rty of an intimate friend. Patrick often siit in the wicker 
r, watching the Mount Pleasant cars swing up Connecticut 
Avenue from II Street, or crawled aciviss the ruglesH tl(H>r to 
lick the shoe polish from the glistening boots of Army officers 
who came to interview his hostess. 

W»rmth of personality eharHcterized Miss Delano's attitude 
toward every one with wIkiui she came in contact. IL^r letters 
to her super\'iHing nurses brimmed over with cordiality and a 
boundless interest in their welfare. At the time the Hed ( -nisH 
Ship sailed, she equippLMl with her own hands all nicmlKTs 
of the various units. 8hc made innumerable visits to the ofliccH 
foreign consuls and representatives that the nurseg' puss- 
ght be vis^d. She held earnest, protra<'ted c(»nfcr- 
th her supervisors, warning them with almost prophetic 
insight of the troublous days ahead of them. A phase of her 
many-sided personality was shown in a letter (May 4, 1015) 
from Helen Fidelia Draper, herself a stanch friend of the 
Xtmixig Service: 




ei 



I expect it may have seemed almost too much of an effort 
for you to come to my house lai^t Friday afternoon. 1 ft?lt 
this especially when I saw you dreHseii in "your lie«t party 
dothes.'* I, too, fee! repaid each time we welcome the uuries 
■ad aend them oiT with a hearty Godspeed. 



^For manj nurses who sailed in intervals during 1015 as 
mtO aa for tiiooe of the Red Cross Ship, Miss Delano's hand 
■Ott^ figure as she wave<l go*xl-liy from the do<'kB or fmrn the 
itA of a tag-bo«t, was often their last definite impression bo* 
low ^'^^'^^^ or perbapa a mist of tears blurred their viaion. 
IWl her "lambs" were now far n^moved from her immediato 
care, dismayed Miss Delano not a whit. She and 
and her secretary packed on the leather ootich 



208 HISTORY OF AMERICAN RED CROSS NLTRSINQ 

in her oflBce the big wooden Christmas boxes which she sent 
to all the foreign units. With her own money and an even 
greater expenditure of thought, she bought the articles which 
went to fill them, The contents of one such box are enumornted 
in her letter to Vaahti Bartlett, at La Panne: four dozen cans 
malted milk; six dozen cans condensed milk; four dozen cans 
cocoa; four dozen cans coffee; one thousand beef cubes; four 
dozen cakes sweet chocolate; two dozen cakes toilet soap; two 
dozen tubes tooth paste ; two dozen toothbrushes ; one dozen 
sweaters. Not content with this, she wrote to the families of 
the nurses then in active service that the Red Cross would gladly 
send their presents through official channels lest they be lost 
in the unsettled shipping conditions 

Many of the nurses' salaries (sixty dollars a month) were 
met through the generosity of Cliapter and individual memlwrs 
of the American Red Cross. I-etters written by Red Cross 
nurses to these donors formed one of the strong personal bonds 
by which Miss Delano endeavored to unite ardent supportc»ra 
at home with Red Cross workers in the field. 

Two hundred and fifty-five nurses including the one hundred 
and twenty-nine of the original units and the additioiuil one 
hundred and twenty-six others who relieved them, were cn- 
gag(^ in war mirsing between Auj^iat, 11)14, and December^ 
1915, Miss Delano vigorously denied in a letter written April 
9, 1915, to the editor of Tlut Survey, the rumors of atrocities 
current at that time: 

I am iiifleeil glad to reas8ure you that so far as we have 
been able to determine, no Ked Cross nurses from any coun- 
try have met with the mutilation spoken of po frequently. 
Oi the treatment experiem^etl by our own units, there b 
ab8^>iutely nt» truth in any such reports. 

One of our unitH was in Belgradi^ when that city was 
captured I>y the Austrians; thousands of soldiers poure<l into 
the hospital and were cared for in the same wards with the 
Serbians already there. The city was recaptured again by 
the Korhian tr«H>ps, ajrain by the Austrians, and the American 
Red Cross remained inviolate. 

Miss Delano felt an intense personal responsibility for the 
nurses' health. She was greatly distresst^-d that their rooms 
were bo often without heat, as a letter of thanks written Janu- 
ary 26, 1915, to the Graduate Nurses' Association of Charles- 



THE MERCY SHIP 



209 



* 



ton. West Virginia, showed. When cables arrived telling of 
the typhus epidemic at Gevgeli^ her anxiety expressed itself in 
an immediate, wholly characteristic recommendation to Major 
Patterson : "May I ask," she wrote, "that six dozen nightgowns, 
two dozen bath towels, four dozen hand towels, four dozen 
boxes talcum powder, Ik? ordered for the use of the sick nurses 
in Si^rhia and delivered as soon as possible to Red Cross Head- 
quarters, New York, addressed to me, so that I may pack them 
in a trunk to go over with the next unit of nurses?" 

To Miss Kruegcr she wrote: **I am more than grieved to 
boar of your illness and that of the other nurses at Gevgeli 
and am so worried for fear you are not able to get any kind 
of suitable food. Were it not for fear that there would not 
be enough nurses to take care of those who are ill," she added, 
"I should not send other nurses into this danger, but with 
this thought in mind, we shall probably seud additional ones 
by the first steamer. It often seems to me that 1 must go 
abroad at once, if I did not realize so completely that my place 
18 here at Headquarters." 

To Miss Gladwin she wrote: 



I am sending over with the unit sailing March 16, garments 
for the nurses to wear when caring for vermin-covered pa- 
tients. We Imve evolved these garments with the ailvi(r of 
peoide who have lived in these eoimtries. While they are not 
especially beautiful, I do believe they will lessen the danger 
of infet^rtion. 

The skirt is made like Turkish tronsers, has litfle exten- 
sions to iU in (he top of the shoes, tying tightly urouud the 
ankles. The waist has no opening through which vermin 
could gain access to the b«)dy except at the neck and sleeves. 
These are arranged to tie tightly as you see. 



Her extreme practicability, which expressed itself by having 
these garments made for the nurses, provoked considerable 
laughter at her expense, in which she would have undoubtedly 
joined more heartily had she not been so distressed, '^*Th© 
aervicc at Gevgeli has been a perfect nightmare to me" she 
wrote to Miss Gladwin on April 17, *'and I have been actually 
afraid to read the cables as they come in. ... I have notified 
the families of all the sick nurses, as it seems to me they 
hare a right to know the conditions. I am simply heart-broken 
to think that typhus has extended to your unit at Belgrade." 



210 HISTORY OP AMERICAN RED CROSS NURSING 

TLi« intt^iise rimtGrnal solicitude did not iu any respect, how- 
ever, iiiJply iudulgencf. Miss Delaiu} wiia a stern discipliu- 
arian. To her supervising nurseB she wrote: 

Do you think the foreign authorities are pleased with the| 
service our nurseH are giving? Tlie only thing that worriea 
me is the possibility of conditions becoming a little lax if 
our units nre not fully occupied. Will you impress upon the 
nurses the importance of dignified ajid professional conduct 
both on and off duty? 

Please do not hesitate to write to me quite frequently if 
you have any worries. Should any unexpected complications 
arise, cable nje. If you think it necessary for the good of 
the service to relieve any nurses from duty, be assured that 
I am ready to support any action you may take, even to the 
extent of sending nurses home. We have many others anxious 
for European duty, so I do not believe it would be worth 
while to temporize much should tlierc be any breach of 
discipline. 

Three principal defects in the organization of these pioneer 
Red Cross units were apparent to National Headquarters in 
1916, a realization of which was to save much confusion and 
unhappiuesa when the Red Cross organized a medical and 
nursing personnel a year later upon the entry of the United 
States into the war. First, when the ^lercy Ship sailed, the 
authority of the chief nurse niul the relation of the medical 
director to the nursing staff liatl not been detimnl. Second, 
some of the nurses themselves .did not seem to possess imagina- 
tion enough to perceive tluit this condititm wws due to the speed 
with which the units were dispatchtnl to Europe and therefore 
called for even greater exercise of their professional ideal of 
loyalty to their immediate superior than would have been 
necessary at lutme. Instead of endeavoring to live \ip to this 
ideal, which was one of the foundation stones of nursing ethics, 
they tof»k advantage of the geographic separation of the super- 
visor from the Nursing Service nt National Headquarters and 
were the means of partially disrupting the discipline and lower- 
ing the morale (»f the entin* medical and nursing staffs. Third 
and most confusing, was the effort to enforce Army procedure 
upon groups of people untrained in its complexities and wholly 
ignorant of its uses, as were the surgeons and nurses of the 
S. S. Red CroHH. 

The first manifestation of an absence of esprit de corps 




THE MERCY SHIP 



211 



I 



• 



presented itself in an open disloyalty between several nurses 
and thoir sHpervisors. This was due in part to a lack of sup- 
port given by the medical director to the supervisor and in 
part to the aUitude of a few nurses who seemed to regard their 
foreign assignment as more of a sky-larking expedition than 
B diflcipline<l war service. Perhaps liliss Delano and her su- 
pen'is4^r8 in their jealousy for the reputation of the American 
Red Cross Xursijig Service abroad, may have set up more rigid 
standards tlian graduate nurses, long since freed from the 
9tvcre discipline of training school days, would brook. At any 
rtte, individual nurses complained to the medical directors of 
Tftrious units and the directors, some of them yoimg men whose 
service as internca had been cf>mpleted only a few years before, 
undertook to adjust this ticklish problem with the supervisors. 
But these women had enjoyed many prerogatives and had 
home grave responsibilities at home as superintendents of hos- 
pitals and training schools. They resented the interference 
of the youthful medical men in disciplinary matters relating 
pnrely to the nursing staff and accused the directors of lack 
of cooperation and the tale-bearing nurses of disloyalty. The 
dire<*tor8 then reported their views to Maj(u* Patterson, while 
the stipervisors laid their cases before Miss Delano. Lively 
discussions ensiled at National Headquarters, To secure effi- 
cient nursing service, iliss Delano maintained, as did her 
topera-ising nurses, that the same system of discipline prevail- 
ing in every well organized hospital should exist also in the 
Ked Cross organization, that all matters relating to the discipline 
of the nursing staff should be handled by the supervising nurse 
lliFDUgh recommendations to the medical officer of the unit 
and fo the chairman of the National Committee on Red Cross 
Nursing Service at Washingtouj D. C. ; and that the director 
of the unit should support the authority of the Rupervisor as 
long B8 her services were satisfactory. After thorough investi- 
ICatioUf Major Patterson iu January, 1015. issued the following 
letter of instructions to all directors for foreign units: 



All of your dealings with the nurses should be through 
senior superviHor. . , . Your surcreons should be in- 
'Straeted to refer all requents for detail of nurses, orders, 
complaints, or other matters regarding the nurses to you to 
be acted on by you at your discretion. When these units 
vere originally sent to Europe, the surgeons were instructed 
to this efftH't. In other words, if any of the doctors desired 



212 HISTORY OF AMERICAN RED CROSS NURSING 



to have instructions given to any of tlie nurses or to make 
complaint, such matters were to be brought to the attention 
of the senior rlirector, who would transmit the game to the^ 
supervising nurse, who in turn would give the necessary 
instruction to the nurses. 

The matter of assignment to duty of nurses and their 
general superviniou should l)c left entirely in the hands of 
the senior supervising nurM'. Thesf iristruc'lit)us do not 
mean that doctors working with nurses should not give them 
the usual instructions and orders common between ward sur- 
geons and the physicians and nurses working with thum. , . . 

[f in the opinion of the 8iii>ervisiiig nurse, any of the 
nurses under her charge are deficient in conduct or unsatia- 
factory to her in any particular and she so recommends, you 
shoidd return such nun^Cfj to the I'nited States, merely obtain- 
ing sulticient information from the supervising nurse to 
satisfy yourself that tbere has been no miscarriage of justice. 

As long as the supervising nurse is satisfactory to you, 
you should sustain her authority on all occasions. If at 
any time her services are unsatisfactory, she should be re- 
lieved from further duty, a temporary supervisor appointed 
in her stead ancT this office notiiied by cable, 

A letter written to one of her supervisors, April 28, 1915, 
outlined Miss Delano's interpretation of these instructions: 

It seems to me consistent and necessary for discipline that 
the director have the power of removal of the doctors serving 
under him and of the supervising nurse of the unit. So 
long as the supervising nurse remains in ctiarge of the 
nurses in the unit, any recommendation made by her should, 
I think, be accepted by the medical director wiihout question. 
All the dealings of the medical corps with the nurses, ex- 
cept in the matter of orders for patients, should be absolutely 
tlirough the supervising nurse and she should be held 
responsible for the discipline and maintenance of order of 
the nurws under her. Any recommcjidatioiis for the removal 
of a nurse should, however, be made by the supervising nurse 
through the medical director, unless he should refuse to for- 
ward this recommendation. Under these circumstances, I 
think the supervising nurse would be quite justified in com- 
municating with me direct, although every effort should be 
made to come to an agreement with the medical director 
in regard to the recommendation so that after action was 
taken, the supervising nurse could be sure of his support 
and approval. 



THE MERCY SHIP 



213 



Miss Delano was undcviuting in her support of the super- 
viaon^ even refouimrndiug the immediate recall of individual 
tiMrst*8 whose complaiutB had Grst hrought aUiut the loss of 
hiUTDony. The following statement of Miss Dt^lano's rejisous 
for her support of the supervisors was contained in a letter 
written l»y her to the supKjrvistir of several nurses who had 
been relieved from duty at the end of six moutlis: 

I think they were a little surprised to find me waiting for 
them on the dork, but in spite of that they seemed glad to 
see me. I asked thera to report to Red Cross Headquarters 
as soon as they had arranged for the inspection of their 
luggage. 

They came quite willingly. I asked them to tell me exactly 
what their ditlieulties had been. No one seemed particularly 
anxious to talk and it was only after more or less quei^tioning 
that they began a discussion of the matter. I was really sur- 
prised at the little they had to say. I explainetl to them my 
idea of the relation whidi should nave existed between nurses 
and the director and that the supervisor represented as far 
as they were concerned the autliority of the Red Cross, acting 
in my place. 

I also told them that I felt under obligation to support 
to the last any supervising nurse unless some definite eliarges 
could be hrought against her, that it was not a question of 
tlie individual but of the principle and that I should have 
supported any one of them with equal willingness had they 
been selected as supervising nurse. This seemed to appeal 
to them as reasonable and just and I am hoping that they 
went home with rather a different idc-a of their relation to 
the Hed Cross Nursing Service. 

Of the seven nurses who were relieved from duty for in- 

>rdiuation, she wrote: *'I have not seen Miss nor do 

I intend to do so until you are iu this country. Nothing will 
be done about disenrollment until both sides of this question 
are beard." A letter to a nurse, a close friend, who dilTcred 
radically in opinion from the nie<lieal director of her tinit, 
illustrated Miss Delano's impartiality, a quality which com- 
nuwdcd the respect of all who knew her well: 

I wish, however, to tell you exactly what I said to Major 
Pfttteraon, so that you may understand my position. Of 
course. I know (and so do you) that sometimes you are a 
ItUk "difficult;*' but I realize that in this ineident there had 



214 HISTORY OF AMERICAN RED CROSS NURSING 

been great provocation and I think that yon know me well 
enough to feel sure that I have only the good of the gervice 
at heart, even though this me-aut the &acritice of my dearest 
friends. I have said that I would not consent to your re- 
turn, except on your own request, until the arrival of the 
new medical director. If, whrn he hns looked all the ^Touud 
over, he feclg that your relief will lie a benefit to the service, 
I shall be willing to accept his recommendation. 

Had there been time on the part of National Headquarters 
to establish a definite plan of organization and communica- 
tion before the units sailed, much discouragement and unhap- 
piness would have been avoided when the units found them- 
selves face to face with these difficulties in the far corners of 
Europe. Miss Delano appreciated keenly her share of this 
responsibility. In a particularly trying instance, she wrote to 
one of her supervisors with singular tenderness and sympathy: 

I do not wish you to feel in any way that your work has 
been in vain. I am most unrewmciled that things luive been 
allowed to drift along to such a futile ending, but if you 

have had ditljcuUiee in , I certainly have not been 

free from them at this end. Never for one moment have I 
faltered in my support of you and your policy, nor have 
I douhtcd for one iiionient that all wuuld Imve been well if 
you had received from the beginning the support due you, 
not only professionally but personally. 

Your letter of discouragement makes me feel as if I had 
failed you, I have taken the liberty of reading the paragraph 
of your letter, in which you ask to he transferred to another 
country as one of the "rank and file" to Miss Boardman. It 
may comfort 3'ou a little to know that she regrets as much 
as I do all the unplcat^ant experiences you have met. 



Two years later, Miss Delano said to Miss Hay, then re- 
turned from Europe, "No one will ever know the difficulties 
I had in trying to support you super^'ising nurses, nor what 
Miss Boardman has done in trying to secure for nurses the 
proper relationship and authority which she felt was due the 
^Nursing iService in the Red Cross organization." 

Among the mass of correspondence at National Headquarters 
which contains the history of tlje Mercy Ship, there appears 
only one letter of derogatory criticism of the nurses as a whole. 
This estimate was given by a Bntish Matron and it will be 




THE MERCY SHIP 



215 



I 



t 



ippreciated that she was prejudiced to Sf>me dep^ree by national 
ditferences in training, preeedont and teinperanient which placed 
llie Ameriean uuraee working under her in a strange environ- 
ment, at grave disadvantage: "I think fow of them have the 
real nursing instinct or love of h\imnnity about them," the 
British nurse wrote, **they arc keen on their own comfort. 
Their thcor}', I thought, seemed better than ours, but their 
practice not nearly so finished as that of a good English nnrse. 
Their discipline was nowhere and their independence too awful.*' 

Aliss Delano respctnded : "1 am always glad to hear both 
aides of a question and will take up the matter with the super- 

mors in charge of those units. The service at has also 

tried the very souls of our nurses." 

Xational Headquarters recalled fourteen of the foreign units 
October 1, 1015. Belgian Units Nos, 1 and 2 remained at La 
Panne until the completion of a year's service. The Yvetot 
Unit was no longer under the American Red Cross. In the 
Annual Report for 1015, Major Patterson stated the reasons 
for recalling the surgeons and nurses of the Mercy Ship: 



As the war had been in progress for nearly a year, it was 
felt that the sanitary- eerviee of the various belligerent 
countries, as far as personnel was concerned, should be well 
organized and that with few exeeptions they were in such a 
position that further assistance of surgeons and nurses from 
the American Red Cross was no longer greatly needed. This 
was not true, however, regarding supplies, which it was felt 
would tuteadily diminish. These would be increasingly diffi- 
cult to obtain and. therefore, would continue to be needed in 
varying amounts by all warring countries. 

The money that otherwipc would he required for the pay- 
ment of salaries, travel and other necet^sary expenses would 
be saved and the funds thus released would be available 
to continue the purchase of medical, surgical and other hos- 
pital supplies for the Red Cross societies of the belligerents 
for many montlis. 



m Although she had expressed a fervent hope that the nurses 
" should return immediately to the United States, Miss Delano's 
iuieri3st and encoura^ng letters followed many of them through 
ihcir further 8or\'ice in Europe. Four nurses remained on 
sfficdal foreign duty in Serbia and Bulgaria. Mme. Slavko 
Otouilch, wife of the Under-Secretary of Foreign Affairs in 
Serbia, bad requested in July, 1915, that the American Red 



216 HISTORY OF AMERICAN RED CROSS NURSING 

Cross organize a unit of two doctors and two nurses to estab- 
lish in Nish a hospital for infanta and young children. Funds 
raised by Mnie. Grouiteh were turned over to the Red Cross 
to defray expenses. With Dr. Louise Taylor Jones, of Wash- 
ington, D. C, as director, Dr. Catherine Travis, New Britain, 
Connecticut, as assistant, Mrs. Maud Metcalf, of Bellevue 
Hospital, and Miss Grace Utley, of Hahnemann Hospital, New 
York City, as the nursing personnel, the ^labe! Grouitch Baby 
Hospital was opened August 20, 1015, at Nish, Serbia, there 
to exist for a few brief crowded months. 

Dr. Jones had started the dispensary under canvas. The 
main building was opened October 1. Mme. Grouitch de- 
scribed this first Serbian baby hospital: 

The Serbian Qovernnient has given us a really nice build- 
ing, the former Old Peoplrs' Home. Over three hundre<l cases 
have been treated in the dispensary during these first five 
weeks. Women walk all ni^ht from remote villages to bring 
their children. It is heart-breaking to see the wretched, 
absolutely starved little bodies and the fearful cases of hernia 
due to the poor mother and baby having been uncared for at 
birth. 

The white enameled cribs and beds are the delight and 
wonder of all. The diet kitchen with its stove and special 
arrangements, was marveled at with almost religious awe 
by the iwanant women who heard for the first time of the 
nccessar}' care in the preparntion of thoir ehildren's food. 
The store-rnom was viewed willi that respect always given 
to abundance by very poor people. 

In September, 1915, after the hospital and clinic were well 
established, Dr. Jones returned to the United States, leaving 
Dr. Travis in charge. 

In addition to being a hospital center boasting eleven mili- 
tWy and civilian institutions, Nish was the seat of the Serbian 
Oovernmont. In nearby Krnguycvatz were located the arsenals. 
A member of the Grouitch Baby Hospital described the move- 
ments of the Serbian troops: 

For ten days the trains have been constantly transporting 
soldiers to the Rnlgnrian frontier, train after train, day and 
nipht. Miles of men march through Nish. 1 have waved 
to them from the hill where our rlinic is situated and they 
answer with a shout At five o'clock one morning, in the 




THE MERCY SfflP 



217 



pouring rain, a train filled to the guardn passed by with 
soldiers standing in straw on open freight cars, all siuging 
at the top of their lungs: "There is my Serbia; There is my 
home!^' 

If the wounded are brought back to Niah, our Baby Hos- 
pital will at uncc be turned into a military one. 1 kuow we 
shall take care of the grown-ups with as much zeal as wc give 
the babies. Even if we have soldiers in every bed and on straw 
ftAcks in the halls, we will keep the clinic going for the 
mothers. 

The Austrian-Bulgarian offensive was hurled against Ser- 
bia early in Octol^er, 11)15. The Mabel Grouitch Baby Hos- 
pital became a field ainbulanee Octolter K? and with niem- 
hers of the sanitary commission hastened to the front. Grace 
Utiey described the flying squadron of mercy: 

For ten days we were on the firing line, giving First Aid 
to the wounded on the field. Tliis sometimes meant imme- 
diatp amputation of a limb, operation on the brain, emergency 
surgery of all kinds. The bravery of the men was magnificent; 
for some, one prayed for swift death. 

We saw the big guns silence two batteries. The caimonade 
of the Austrians and Germans was a solemn tiling to ht-ar. 
We evacuated before the on-coming enemy; moving back a 
station, we set up our tents anew for the wounded, so that 
our "Front" was a constantly changing one. 

We now await here in Nish the arrival of the Bul^rs, 
the Turks, the Germans. Many places around us have fallen ; 
our turn come.s soon. The Baby Hospital under the Stars 
and Stripes and the Red Cross flag goes on until we are 
called again to the frnnt; or until the floods of woundod 
turn this into a military hospital; or until the Bulgars shall 
order us on our walk with thousands of other refugees to a 
port where a ship will take us home; or until we shall be 
taken prisoners of war. 

Of the lawlessness which broke out in Nish immediately 
before the Bulgarian occupation, Miss Utley wrote: 

The fitorehouses not under American jurisdiction in Nish 
were Uirowu u(»en to the public. The place where automobiles 
were kept, as well a* any other things that could be of use 
to the enemy, were burned up. Casks of wine were broken 
open and people carried it into their houses in pitchers, pails, 
or any utensil handy. Much of it streamed over the mud. 



218 HISTORY OF AMERICAN RED CROSS NURSING 



Even little children were drunk iu a short time. Some of the 
people broke the windows of their own shops and carried 
away things without discrimination, or simply dcslroyed 
them. The powder magazines were blown up at one o'clock in 
the morning of the fourth of Novpnil>er, Add to the terrilic 
eJcplosions the constant crackling sound of the flames as they 
licked up tlie gunpowder; tlie sight of mighty towers of 
fiolid flame here and tliere and at intervals a fresh explosion! 
One can realize fully how it might affect men who were ill 
and weak and helpless. For a short time we had almost a 
panic within our compound. 

Of their sole protection, Maud Metcalf wrote: 

Upon our return from the front, we were requested to 
take over a military hospital filled with wounded Serbians. 
We went out to its crowded wards one wet dreary afternoon 
and by the next morning all the uthcials had left, leaving u& 
with 1100 patients. We were not the most cheerful people 
in the world. To our dismay, moreo\cr, we found that we 
were left without an American flag. 

I walked three miles to a village to And all the stores 
closed and tlicir windows tightly boarded up. After a great 
deal of talk, a shop-keeper pulk-d down one board and let 
me in. 1 lK)ught some rcil and wliite .sateen and a little square 
of blue cloth. Back 1 hurried to the hospital and we pro- 
ceeded to make a flag, the other members of the unit cutting 
out stars while I sewed the stripes together. All of us won- 
dered what our fate would be. I sat up all night to finish it 
and in the morning wc cut oil a limb of a tree for a pole, mtiled 
the flag to it, fastened the pole to a window frame and there 
it hung through sunshine and storm for five months while 
we stayed at our post. 

At half-past ten o'clock on the night of November 7, 11U5, 
the Bulgars ai»d Turks captrired Nisli and on the next day the 
Germans came in, 60,000 sti-ong. The military hospital, flying 
the Aincricau and Red Cross flags, remained unhRrmed and 
the nurses and surgeons cared without discrimination for the 
wounded of both the Allied and the Central Powers. 

National Headquarters cabled the recall of the Mabel Qrou- 
itch Baby Welfare Unit in Novcmln'r, IDIH. Maud Metcnlf 
reported in December to Helen Scx)tt Hay in Sofla. Grace 
Utley and the other Americans returned home during 1916 
after many delays. 





THE MERCY SHIP 



219 



During the Bummer of 1915, Helen Scott Hay and Rachel 
Torrance had undertaken in Sofia, Bulgaria, under gracious 
Queen Eleanora'a protection, the organization of the training 
school first proposed in 1913. Before takinj? up the details 
of this project, it is of interest to read Miss Hay's characteriza- 
tion of its sponsor: 

What Queen Elizabeth was to Hungary, that was Eleaimra 
to her adopted countr)% — a woman whose constant thought 
vas for the help of her people. But for her wisdom and in- 
comparable strength and fearlessness, the small though con- 
rincing demonstration of good nursing methods in hospitals 
and in home would not have been possible in Bulgaria in 
li>15 nor probably for long years to come. 

Of the German house of Heuss and brought up near Vienna, 
her family, father, brothers and sisters, were all noted for 
their kindness and generosity. Her concern for the sick be- 
gan when the parish priest taught her the simple remedies 
which she applied in care of the sick poor of the neighbor- 
hoo*]. In the Husso-Japnuese War, she had good oppurtimity 
to learn the value of skilled nursing. During the Balkan 
Wars, she as Queen M'as head of the Bulgarian J{ed Cross 
tnd then indeed the lack of good nurses and good uureing 
schools wai« impressctl upon her. Thnt she at once began to 
plan how this defect might be remedied is characteristic of 
ner sympathetic desires for her people and of her indefatigable 
purpose. . . . 

In her manner, she was simple and without ostentation 
and repeatedly surprised even lier best friends by her sound 
wisdom and good sense. There wns Dotlang of the dilettante 
about her. In questions of curriculum and discipline, she 
would have been a helpful epeaker in any group of nurse in- 
Btructors. ... No detail was too iusignilicant for her at- 
tention if it meant someone's liappiness or added comfort. 
A village wedding, an insane soldier, the ambition of an or- 
phan girl for an education, — everything that would help she 
did at once. Schools for the deaf and t!uTnb, help for the 
blind, care and cure of the tubercular, a thousand interests 
big and little were hers and of her strength aud her means 
she gave to the utmost. . . . 

Two ather women instrumental in the organization of the 

'Queen's School" were ^ladanie Bakiuetieff, wife of the Bui- 

ian diplomat whowas later Ambassa<lor to the Unitetl States, 

%id Miss Inez Abbott, director of the Vj'xrhi iSchool in Samakov.. 



220 HISTORY OF AMERICAN RED CROSS NURSING 



Miss Hay wrote of her assignment to Bulgaria and her 
reception there: 

To Kief early in 1915 came Mr. Bicknell from Bulgaria, 
where Queen Eleanora had diecusised with him her ardent de- 
sire to see the School established, even though the times con- 
tinued uni)roi)iti()Us. As 1 wuk then nUoui to return to 
America. Mr. Birknell felt thut I chouh! ^o tu Sotia and 
acquaint myself witli cnnditionst there; so early in .hine, lIHo, 
I went to Sofia with tlio luidcr^laiiding that my mitision was 
only to inform myself of Londitiims sur-h as would be heipful 
should the Hchotil project be resumed later. 

From the moment of my arrival in Sofia, the Queen was 
most hoHpitable. . . . During the weeks wliich followed, I 
visited the Alexander, Hed Cro8s and Clementina Hospitals, 
met nuniorons men and women favorable and unfavorable to 
our plan and hud many conferences with the Queen. At this 
time Bulf^aria scented to me to l>e singularly peaceful com- 
pared with the militiiry Kust^ia I had just left. True, she was 
still weary from the Balkan Wars and who could tell what 
the King, Cabinet or Minister might do when faced with 
the increasingly complicated situation due to the European 
War? 

Scarcely had my fir.=t week in Bulgaria passed before I 
found thtit the Queen was arriving at the panic conclusions 
I held: that ihc need was beyond question and that the time 
was as opportune as it was ever likely to be, "You are 
here,*' she said, "and we should begin at once. There will be 
big dit!iculties and much opposition but my shoulders are 
broad.'^ 

The plans proposed months l>efore in Washington were 
that the Alexander (the (jovernment) Hospital of 11)00 beds 
should be used for the practical training and that in turn the 
Hospital would provicle board and lodging for the entire 
School besides a stipend of 41) levs monthly for each pupil. 
The Samaritan SiM-iety of Sofia were to proviile uniforms 
and te.\tb<»oks and to work to swure funtls for a permanent 
nurses' home. But times had changed and interest shifted 
and the only concession which the Queen could get for the 
School after days of weary effort was the nursing care of one 
pavilion and that without return of any sort. A private 
house in the neighborhood was secured for the nurses' home, 
was fitted and fiiniished in exquisite taste under her per- 
sonal direction and all expenses with It, with the pupils' gen- 
erous uniform allowance and other items came from the 
Queen's private purse. 



THE MERCY SHIP 



221 



On September 15, the School was opened with Miss Hay as 
I^rector and Hachel Torrance uh assistant. The pupils num- 
bered eight; one of them hud had full college training; two 
had had two years in collegt^; two others were graduates of 
h\A ichoola and the rest had had some years in high school. 
All were Bulgarian and all hut one spoke English. A course 
of study covering two years and corresponding to the **Standard 
Cnrriculum" had been adopted by Miss Hay. 

Of the fortunes of the School, Miss Hay wrote: 

On the very first morning of clasFos, the Queen brought us 
the news that Bulgaria was on the eve of mobilization, having 
thrown in her fortunes with Germany and Austria. We must 
therefore plaice our pupils at once, she said, in the Alexander 
Hospital to assist in caring for the soldiers. I begged for a 
few weeks, even a few days, for preliminary training and we 
were able to give almost a month to it. In the excitement of 
a nation going to war, no wonder we found our pupils un- 
usually apt! All day long they made bcfls aud poultices, gave 
each other baths and simple treatmenti» to the music of a 
military band or of fife anil drum that In the parade ground 
hard by was continually welcoming troops of war-weary vet- 
erans and exuberant recruits pouring in from all quarters ol 
the kingdom. 

Then fightmg began off to the West and North and we 
made ready our pavilion at Alexander Hospital. As a good 
nurses' school^ we must stand for the highest standards of 
cleanliness and order. Scarcely was the last yard of paint 
scoured white, the last todet made spotless, the hist bed 
benzined, however, when the German Red Cross with doctors, 
nurses and vast supplies began arriving in Sofia to take over 
tlie direction of all military hospitals in Bulgaria. To Alex- 
ander Hospital came the chief, Dr. Goldammer. and his as- 
sistants. With our (lupils we were left the nursing care of 
our pavilion. But not for long were we allowefl to enjoy 
our clean quarters. A nurses' school meant to the (Jerman 
direction undesirable complications aud (most obnoxious!) 
division of authority and they would hove none of that. So 
with tbank-yous and good wislies all around, our School was 
transferred to Foteenoff Hospital nearer the center of the 
city. 

Foteenoff Hospital was under the Queen's control and was 
dincted by a sympathetic Bulgarian physician. Dr. Michael- 
ovaky. For tivc months, the ^'Queen's SchooF' flourished there, 



222 HISTORY OF AMERICAN RED CROSS NURSING 

but early in 191C Dr. Micbaelovaky grow ill and a German 
physician was put in charge and German Sisters were installed 
in the operating-room* iiiss Hay wrote: 

These were the days of increasing animosity between Ger- 
mans and Ameripans. Moreover, German methods of train- 
ing are whoily differeut from ours. And again arose the 
question of divided authority. Sad it was but unquestionably 
true that the building up of a good nurses' school under 
American methods was not then feasible. The Queen, too, 
came to the same conclusions, probably on account of the in- 
creasing opposition of tlie King and Prime Alinister to her 
giving any longer her favor and protection to Americans, 
So the transfer of the pupils of our school was made and 
back they went to the Alexander Hospital, . . . 

However, the Queen was not the one to relinquish easily a 
project as dear to lier as was the ijitroduction of American 
nursing methods in her countrj-, so she begged Miss Torrance 
and me to remain in Bulgaria so that the School might he 
resumed speedily as soon as the war was over. Even if the 
Germans did not further desire our services, there were many 
Bulgarians whom she felt we might assist. And was it not 
to help these that we had come to Bulgaria? And so it was 
decided that we coubl help most effectually in the care of the 
refugees. In Philipo|K»Io8» secon<l citv of Bulgaria in size, 
with a normal population of 00,000 there were a large number 
of refugees, some the remnants of other Balkan Wars, others 
just arriving from the Greek and Macedonian fronts where 
fighting had already begun. 

National Headquarters cabled its approval to the change in 
assignment and authoriz(»d Miss Hay and Miss Torrance to 
spend their small balance of five hundred dollars in general 
relief work. Wiss Hay wrote: 

The plan was that we should work in cooperation with the 
American missionaries under the American Board ; their 
long residence made them familiar with locjil needs. We 
were attached to a local women's organization, the Samari- 
tans, which endeavored to find the nepdie.*tt sick and supplied 
them with milk and eggs. The women in this group under 
the able leadership of Sirs. Stt'phen Kaltcheff. .st<x>d sponsor 
for us, two strange Americans, and undoubtedly their intro- 
duction went far to arouse for us feelings of respect and 
confidence. 



THE MERCY SHIP 



223 



In the disorganization of war rlays, there were virtually 
no other social agencies with which to cooperate. During our 
stay in I'hilipopolis, a union was ctTwRnl itf Hincral groups 
repre*ienting the several religions of that cosmopolitan city, — 
Jew, Pravo-Slav, Catholic, Armenian, PrDtestant, Moham- 
medan. — and funds were collected, tJiongli our wurk really had 
little help therefrom. Intentions were of the best hut the 
ideas we stood for were new to the Oriental mind which could 
not be expected to act upon such short notice. 

In Philipopolis, there were two physicians for the city poor, 
but with enormous clinics daily and with the work of sani- 
tary officers for a prodigious area, they could give little, very 
little, individual attention to anyone and the person too ill 
or otherwise unable to drag himself weary miles up the hill 
to the clinic must get along without the assistance of a 
physician. Therefore, after the city had heen divided into 
six main parishes, each of us undertook to cover three of 
them as best we could. Through the "poor lists" supplied by 
the mayor's office, the advice of the parish priest, rabbi or 
Mohammedan hodji, we were able to find an*l to assist many 
of the most need}*. At firtt we sought them. Soon they 
sought us and after that the question was how much we 
couUl manage to give to all who needed help. 

The needs and problems were legion and it took careful 
planning to make our efforts most effectual. The distances 
were long; there were no streetcars or Fords and the 
Ttirkish cobblestones or foot-deep mud was wearisome. Our 
clientele was a motley one, — as varied as the patches in 
our Turkisli Fatimalfs ragged and voliuuiiiauK trousers. 
Resident Bulgarians, Spanisih, Jews, Greeks, Turks and 
gypsies; refugees from Macedonia, Greeti?, Turkey, Serbia, 
Houmania, e^ch holding himself still a good Bulgarian but 
marked in dress, in custom and often in religion by the 
land of most recent sojourn. The Wallachian nomads 
with their flocks and herds were frcquei»tly in our district, 
alway-i knittitig, knitting, on horseback, or walking or stand- 
ing go^'siping with their neighbors ... To know and be- 
come a useful though a very small part in the lives of all 
these kindly, needy folk waa an experience interesting indeed 
beyond my power to tell. 

Kverv Beason seemed to bring forth its special difficulties 
ind its special crop of "miseries." Miss Hay continued: 

No sooner had we gotten the epidemic of boils under control 
than mumps and whooping-cough came along; always we had 



224 HISTORY OF AMERICAN RED CROSS NURSING 



scabies and malaria; am] fltarvatiou that showed in the waxy 
ashen faces everywhere. Kations were becoming more and 
more scarce and with the rold months, the great need of soup 
kitchens was evident. And then came to us from our blessed 
American Hed Cross the sum of five tliousand dollars, a 
primely gift indeed! At once we secured and salted down 
three big hogs, bought up potatoes, onions and beans and be- 
gan to unwind the endless meters of rerl tape nocessiiry to 
procure through the military authorities flour for our bread 
to be served with the soup. Securing kitchens and needed 
equipment was well under way when came a thunderbolt, — 
we were recalled to America. Facing the inevitable, funds 
and the soup kitchens were put in the hands of a strong com- 
mittee who were able ta extend their usefulness over the worst 
of two winters. Visiting nursing was given over to three 
Bulgarian young women, one of whom had acted aa our 
interpreter and assistant. Two of our old pupils from Sofia 
assisted for a time and were succeeded by others from the 
Sofia School for two years or more until lack of funds made 
necessary the closing of the activities. 

Looking back over our work in Bulgaria certainly we saw 
it not as we had planned; it seemed unfinished and sketchy, 
the field too enormous for satisfactory arcomplishment. But 
we had helpeil in a time of great need and that which we had 
done in the Nurses' School and in our demonstration of visit- 
ing nursing was to create a desire in the minds of the people 
for American methods of skilled nursing. 

Of the resolute Queen, Miss Hay wrote: 

To Queen Eleanora, it was a sincere grief that war condi- 
tions interrupted the development of the School. Still more 
disappointing was it when we were recalled; for as long as 
we were in Bulgaria, she felt that we could resume the School 
as soon as the war was over. Her optimism and consuming 
wish speak out in the last letter reeeived from her: "Ciod 
grant that the work established by you may grow and remain 
in gitod form, 'til in better times helpful American hands 
may work at it again!" 

In a beautiful garden beside an ancient church on the 
8lo|>es of Vitosha, guardian mountain of Sofia, lies the good 
Queen, watching perhaps as she said she would, over her 
dear Bulgarian children. Truly the memories of her alms 
and her good deeds arise like sweet incense to immortalize the 
name of Kleanora of Bulgaria. And as one who gave the 
impetus to adec^uate nursing standards in Bulgaria, abe de- 



THE MERCY SHIP 



225 



eerreg a worthy pkce in a history of nursing accomplish- 
ment 

Many other nurses had remained in Europe after their 
official recall in 1915. Thirty-seven volunteers from the units 
at Vicuna, Budapest, Gleiwitz and Kosel went into Russia and 
Siberia at the request of the German Government to distribute 
relief to German prisoners. The Russian Government had a 
aimilar project under consideration to send American Red 
Cross personnel to care for Russian prisoners but the plan 
did not materialize. "No higlicr tribute/* stated an editorial 
in the Am€ri<:an. Journal of Nitriting (October, 1915), '*ha8 
been paid to the service rendered by our Red Cross workers 
than this request from two warring countries for a continuance 
of their services for the benefit of prisoners in exile." 

Sister Anna Reutinger was supervising nurse of the Ger- 
man prison units. I>r. Cary A. Snoddy and eight American 
surgeons composed the medi<»al staif. Before this detachment 
wan relieved during the spring of 1916, they had visited and 
distributed medicines and supplies to German prisoners at 
Moscow, Ugresh, Ryazan, Penza, Saratov, Astrakhan, Samara, 
Orenburg, Omsk, Novo-Nieolaievsk. Tomsk, Irkutsk, Tashkent 
and Kasan. Sister Anna described to Miss Delano the kind of 
work accomplished: 

Of the uninjured in transit, we gave comfort and relief to 
\7M officers and 11,271 soldiers; of the recently wounded and 
ill, l)edridden and helple&s, we aided 7S8 officers and 24,4(>6 
privates; of the incurables we aided 78 officers and 8436 
soldiers. 

The evacuation hospitals where invalids were concentrated 
were the school buildings. The recitation rooms and halls 
were overcrowded with victims of advanced tuberculosis, theii 
beds closely ranged side by side. It was estimated that eighty 
per cent of the exchange prisoners were affected by this dis- 
eai»e. the White Plague indeed ! I can never forget their 
bloodlesH faces, nor the sound of their hoarse voices beseech- 
ing in whispering tones: "Sister, do you think I shall live tc 
reach home? I want only t^^ live one day at homo again in 
Hungary," and then the skeleton hand and arm would steal 
from underneath the bed clothes in an attempt to take mj 
hand and kiss it for the solace and conuniseration offered. 
The psychopathic cases were usually melancholia or the busy, 
chattering type, the subject of their mania being invariably 
the horrors of war. 



226 HISTORY OF AMERICAN RED CROSS NLTISING 

Scurvy worked ^eat havoc among the captiree. We aided 

850 victims of thie disease whose teeth had falK^n out and 
who were uaable to walk from stiff and swollen joints. In 
fact, it seemed that every sickness known to civilized man 
found here a ready prey. A major general suffering from 
nephritiB told me that the lieutenant general to whom he 
had surrendered was a prisoner in his country and on hia 
return to his home he vvouhl endeavor to have his captor re- 
leased and sent hack to Kussia. **We are two broken men," he 
said, "with only perhaps a few monllis more, which should be 
spent with our families." 

We can readily oomprohond the depths of their despond- 
ency, returning blind, crippled and ill, many of thcra to 
destitute families and many of tliem to endure in pain and 
poverty a living, lingering death. We often wondered if our 
twentieth century civilization wae but mockery, or if it had 
only endowed barbarians with more elficient and ruthless 
weapons and methods of slaughter. Where, we asked, is the 
culture, where the loving message of Christianity, where the 
humanity that can countenance such savage and infamuuB 
cruelties? The only answer from this gruesome slaughter- 
house of hopes and desires was the pathetic prayer of the 
sufferers for peace. 

Although by Christraas, 1915, the Red Cross had closed its 
foreign program, Miss Delano, as chairman of the Xatioual 
Committee on Red Cross Nursing Service, was in an excellent 
position to gain a bird's-eye view of ahnost every phase of war 
nursing. She saw the American Ambuhince which had been 
established in September, 1914, at Neuilly, France, by the 
American Ambulance Committee of Paris. Here many 
American Red Cross nurses were stationed with Margaret Dun- 
lop of the Pennsylvania Hospital. Phihidelpliia, us chief nurse. 
She saw the first Hansard Unit serving with the British Ex- 
peditionary Forces at General Hospital No. 23. The McGiU 
University and the Chicago MiMlieal units were their close 
neighbors. From peraomil letters written by Red CrosB nurses 
scattered with other organizations in all parts of the world, she 
gathered wisps of information about tlie nursing situation. 
Two memU^rs speaking for the American Anduilanee might 
well have voiced the feelings of other nurses serving in the w^ar: 

We never saw the flashing hattle-line, tlmt arch of bright 
steel that stretches 300 miles between France and Germany, 
we did not hear tlie cannon or long lines of men cheering as 



4 




ITHE MERCY SHIP 



227 



they swept into action, or the <lying horpes scream; we saw 
none of the pageantry of war; bnt we tlid get a glimpse be- 
liiu!] the wenes of its most real, itH inoist lafitin^,^ part. We 
Mw the long ambulance trains, tho^e **river3 of pain" running 
back from the lines; we 8aw stnuig men sobbing with agony 
like ehibireu; we saw them crippled, dying*, wo saw their 
women struggling alone against anxiety and poverty, pale 
women with that look in their eyes which comes of sleeplees 
nights and unshed tears; we heard little children crying for 
the father^s love they will never know again. All thet-e things 
are the necesaary routine of war. We have seen and we can 
never forget," 

At the close of this first early chapter of American Rrd 
Croas participation in the European War, Miss Delano summed 
op the value of the service which had been rendered by the 
American Red Cross nurses; 

Two hundred and fifty-five nurses have been sent to Europe. 
Wlien we think of tlie vayt number of Kick and wounded, the 
thirty thousand patients cared for by our units seems piti- 
fully small. 1 do believe, however, that we have established 
in European countries, where modern training schools for 
nurses have not yet been organized, a definite standard of 
nursing, which will surely produce results later. 

Our nurws have had a valuable experience which should 

be of benefit to our own country. They have learned how 

to care for large numbers of patients all weary, ill, hungry 

and cold an<l to make them comfortable in the shortest poa- 

BJblc time without disturbing the routine of the hospital. 

H'p have learned that women can be mobilized without con- 

»ion; that their chances of illness when carefully selected 

•m to be no greater than men's : that they face danger with 

tequaniniity. We have learned also the special type of nurse 

mcwt desirable for service of this kind. 

Out of this experience we should be able to do st splendid 
piece of constructive work for our own country. We should 
be able to guarantee a satisfactory nursing personnel not only 
for national relief in time of calamity, but for etlicient service 
should our country be confronted with that greatest of all 
disasters — War." 

For the American Red Cross, the first enthnaiasm of world 
ipathy had spent itself. Rut an all-shadowing responsibility 

Amrricnn Journal of \ur8ing. Vol. XV, p. R54. 
"American Red Crosi Annunl Report, 1915, pp. 44*45. 



228 HISTORY OF AMERICAN RED CROSS NURSING 



loomed ahead. Although popular incliuation clamored for 
peace, men and women at National Headquarters stood looking 
ahead to a day not far distant, when American men might 
wait hi a welter of sand, mnd aTid flesh as the trenches about 
them crumbled under enemy fire; when American boys might 
lie in (^afluiilty-clearing stations under a Alexicau sky or in a 
I'l[»niirtli farin-houscj tearing at wounds in blessed delirium or 
biding tlicir turn in stoic consciousness of physical agony. 

War, dimly nsible through diplomatic and economic events 
of li>l'> and 191*J, was hurling at the American Red Cross 
the challenge of ita charter obligation: Look to thine own! 



CHAPTER V 



MOBILI^SATION 



National Headquarters Reorganizes — 7%e Naiional Corrir 
mittee on Red ('ross Nursiruj 6*ennce — The Committee on 
Xuming of the Council of Nafional Defence — Special Courses 
— Special Groups — The Anny School of Nursing — The Nurses' 
Drives — Surgicul Dressings — The Nursing Surveys, 

The International Conference of Geneva in 1803 recom- 
mended "that there exist in every country a committee whose 
miasion consistfl in cooperating in times of war with the hoe- 
pitttl 8ervi(?e of the armies by all means in its power." Suc- 
ceeding Ui all the rights and properties of the earlier organiza- 
tion, the American Red Cross was reincorponited under Gov- 
f'nimont supervision by an Act of Congress approved January 
5, 1905. In the charter of that date under which it still acts 
iimierated four purposes of its creation^ three of which 
irh relief to the sick and wounded of the Military Estab- 
lishment, as follows: 



RKlri 



First To furnish volunteer aid to the sick and wounded 
of Armies in time of war, in n<'e*irdanee with the spirit and 
conditions of the Conference of Geneva of 0( tober, 18(53, and 
also of the treaty of the Red Cross, or the treaty of Geneva, of 
August 22, 18G4, to which the United St^ites of Aiueriea gave 
its adhesion on March 1, 1882. 

Second. And for said purposes to perform all the duties 
devolved upon a national society by each nation which has 
acceded to said treaty. 



Fourth. To act in matters of voluntary relief and in ac- 
cord with the military and naval authorities as a me«lium of 
communication between the people of the United States of 
America and their Army niid Navy, and to act in such mat- 
ters between similar national societies of other governments 
through the "Comite International de Secours" and the Gov- 

229 



230 HISTORY OF AMERICAN RED CROSS NURSING 

erniiients and the people and the Army and Navy of the 
United States of America. 



For two years beforo the deolarntion of war, April 6, 1917, 
the Rod Cross underwent a period of tensely active but silent 
mobilization. The experiences of the foreign units, -whieh had 
witnessed the initial collapse and subsequent reorganization of 
the sanitary fonnations of the WligeroTits, had made clear 
to the Ainerican Red Cross that it must be ready to meet ita 
responsibilities should the United States enter the conflict. 
Even a year earlier, namely in April, 1014, Miss Delano had 
begun making plans for an enlarged eiintlliuent. At a meeting 
of the National Conunittee on Red Cross Nursing Sen'iee held 
April 24, she requested the State Committees to send to her 
lists of nil training schools in the respective states which fully 
met the Red Cross requirements; al94) additioiuil lists of those 
me**tiiig the requirements only in part. She asked further 
for lists of nurses who were especially well fitted to servo 
as (1) superintendents; (2) head nurses; (3) clinic nurses; 
(4) dietitians. 

Under a revision of the By-Laws of the American Red Cross 
adopted by the Central Committee at the annual meeting in 
December, 1915, the National Committee on Red Cross Nurs- 
ing Service, which had been a subcommittee of the War Relief 
Board, was thenceforth to be appointed directly by the Red 
Cross Central Committee and to work under its direction. In 
December, 1015, the members of the Central Committee were: 
William H. Taft, chairman; Gen. Charles Bird; Mabel T. 
Boardmnn ; Admiral William C. Braisted; John W. Davis; 
Robert W. De Forest; Gen. William C. Gorgas; John Bassett 
Moore; Judge W. W. ^forrow; Charles I). Norton; James 
Tanner; John Skelton Williams. At a meeting of the Central 
Committee on Deccmlier IH, 191 ft, tlie Surgeon Generals of 
the Army, Navy and Public Health Service, the presidents of 
the tliret^ national organizations of nurses and a numl>er of 
other offieialB designated by title were made ex-oflBcio members 
of the National Committee on Red Cross Nursing Ser\'ice. 
In February, 11»17, the National Committet*, on its own recom- 
mendation to the (Vntral Committee, was increased to forty-six 
members by tlic appointment ^^{ twenty-three additional repre- 
sentatives from the three national societies of nurses. 

The three relief boards, Le., War, National and Interna- 



I 



- 



MOBILIZATION 



S31 



tional became advisory boards. All activities were grouped 
under two main departmenta: Civilian Relief and Military 
Relief. Ernest P. Bicknell, wbo had l)eea nntional director 
of the organization from his appointment in 1908 became Di- 
rector General of Civilian Kellef and Colonel Jetferson Kan- 
dolpb Kean of the Medical Corps of the United States Army 
was made Director General of ililitary Relief. 

Col. Kean outlined the scope of the Department of Military 
Relief in tbe Red Cross Annual Report of 1916, as follows: 



It has supervision of all the work of the Chapters relative 
to the variuuti branches of military rehef work, such as Euro- 
pean war relief, assistance to our own soldiers, instructions 
in First Aid and Ifonie Care of the Sick, etc. 

It deals directly and without the intermediation of the 
Chapters with the military units such as base hospitals, 
ambulance companies, hospital units, surgical tiections, sup- 
ply depots and naval and emergency detachments of nurses 
which are orf^anized with the approval of the Medical Depart- 
ments of the Army and Navy to reinforce these services in 
case of war. It administers also all agencies of assistance to 
the sick and wounded soldiers of foreign countries and to 
prisoners of war. 



■ These manifold activities were conducted through three 

■ bureaus: Major Robert U. Patterson of the Medical C(>ri)9 of 
the United States Army, wlio had been Director of the Bureau 
of Medical Service from its creation in 1914 was continued 
as IHrector; Dr. Theodore W, Richards, Unitt^i States Navy, 
was in charge of the Bureau of Supplies; and from September, 

11916, Clara D. Noyes was the Director of the Bureau of 
Nursing Service. Upon the last-named^ newly-organized Bu- 
reau was placed the responsibility for all work in connection 
»witii tbe selection of nurses for enrollment and tlie organization 
of nnita of nurses for service, tlie assignment of nurses to 
doty tind all details relating to the courses of instnictiou under 
the Red Cross in Home Hygiene, Home Dietetics, the prepara- 
tion of surgical drttssings luid hospital garmpnl8;^-cverything, 
tin short, except the public health nursing (then the Town and 
Country* Nursing Service), 
Tbe rush of work of every kind during IGlf' is indicated 
in the Annual Report for that year. It shows that incnihcr- 
ship in the Red Cross had risen from 22,000 to some 300,000 



232 HISTORY OF AMERICAN RED CROSS NURSING 



odd aud even that was only a beginning. The appointment 
of Miaa Noycs as Director of the Bureau of Nursing was of 
great moment to the Service. To take up this task of infinite 
detail, untold anxieties and extreme responsibility, she re- 
signed one of the foremost nursing positions in this country, 
that of General Superintendent of Training SchcMils for Nurses, 
connected with Belle\'ue and Allied Hospitals, New York 
City. 

Clara Dutton Noycs had had long experience in the admin- 
istrative work of her profosaion. Bom at Port Deposit, Mary- 
land, she came uf Connecticut parentage. Her father had 
served, as had Alias Delano's, in the Civil War. Miss Noyea 
was graduated from the Johns Hopkins Training Scliool for 
Nurses in the class of 189(5, where she served for a year after 
graduation as a head nurse. She was for s<jme years super- 
intendent of nurses at the Hospital for Women and Children, 
Boston, and later puperintendent of St. Luke's Hospital and 
School of Nursing, New Bedford, Mass., leaving there in 1910 
to accept the general suj)erintendency of Bellevue and Allied 
Training Schools. From 11*13 to IDIG she was president of 
the National League of Nursing Education, and president of 
the Board of Directors of the American Journal of Nursing 
from 1911 to liflS. As a result of her broad and many-sided 
interests she brought to the lied Cross a keen appreciation of 
nursing problems. Professional claims were never ignored 
even in the intense absorption of her Red Cross work. She be- 
came president of the American Nurses* Association in the 
spring of 1018. ser\'ing thus through the trying dayn of war 
and demobilization. 

On April 3, 1916, Miss Delano first approached Miss Noyes, 
who was at that time also chief nurse of Base Hospital No. 1, 
Belleme, the first unit to complete the organization of its 
nursing p<?rsonnel. Miss Delano had hurried to New York to 
confer regarding the I^lle^^le and Presbyterian units of 
nurses, then being detailed with their respective base hos- 
pitals. On her return to Washington, she wrote to Miss Noyea: 

Ever since I saw you at Miss Maxwell's, I have been won- 
dering if you really would consider coming to the Ked Cross. 

There is no doubt in my mind that there is wonderful 
opportunity to develop for this country a sernce such as wo 
never drpsnipd of iti the l)eginning. It is a piece of work 
which needs constant thought and I should be very happy if 




n.u. hi, Bmis and Eutnt; ^^^^^ p^^^^^ jj^,y^^ 



( 

I 



MOBILIZATION 



233 



I 



by any chance you are willing to consider coming to Wash- 
ington. 

The Director General of Military Relief, Col. Jefferson 
R, Kean, has under his department two bureaus, — Medical 
and Nur:?iug Service. Major l*fttterson is chief of the Medi- 
cal Bureau and you would be chief of the Nursing Bureau. 
I should still be chairman of the National ('(iniiiiitteo tui 
Red Cross Xursing Service, but this committee would become 
advisory and could be called upon if needed. 

For several years Miss Delano had been hoping to free her- 
self from the confining office life which she had led since 1009. 
Ber resignation frtun the Array Nurse Corps in 1!»12 to de- 
xoie her attenti»m undividedly to the Red Cross hnd heen the 
first step toward this relinquishment of executive detail. Her 
wish was to establish a capable director of the Nursing tService 
at National Headquarters and to continue holding her own 
position as chairman, thus releasing herself from excessive 
routine. She dreamed, also, of a little home in the e-onntry to 
be prepared for her later years, for she had inherited a love 
of rural peace and quiet from her New Eiighind ancestry. 
The war pressure now gave impetus to her plan for the office, 
but banished that for her own future. 

Miaa Noyes, however, was not at first disposed to give up 
the work at BeIIe^^le, with its large branch hospitals at Harlem, 
Fordham and Gouvernenr, and its specialized schools of mid- 
wifery and of male attendants. On June 1 Miss Delano took 
tip again with Miss Noyes the need existing at National Head- 
quarters for an able organizer and executive. She wrote: 

1 am still hoping that you will be able to come by the fall 
and it would be my idea to build up a definite group of nurses 
who would really be assistants to the "Chief of the Nursing 
Bureau*' or "Superintendent of Nurses" or whatever the new 
position may be called. This would relieve the Washington 
Othee of many detailH and would divide the work bo that local 
interest would be maintained, still leaving the direetiou and 
final word at Red Cross Headquarters. 

We must have a stroug woman in Washington! There is 
too much at stake now to take any chances and I feel in my 
very soul that you are the person for the place. Miss Board- 
znan adds her persuasion to mine. 

A letter written five days later gives a more vivid picture 
of the press of work at Headquarters, and shows that Miss 



234 HISTORY OF AMERICAN RED CROSS NURSING 

Noyea was giving grave consideration to Miss Delano's urgent 
appeals: 

I am hoping that it may not be necessary for you to t^nie 
until you can do so with an easy mind concerning Bellevne. 
It is nn awful wrench pven at the best to give up such uii 
important work and 1 am willing to do my share. Things 
were protty had here when tlio rush first came, for it was 
dillif'iilt to get extra stenographers, — at least good ones. So 
many of them had gone from the Departments to **the front,*' 
— in this case over to Fort Meyer. We are getting on better 
now and the feeling that you are available if a great need 
comes makes it all much easier. 

^e can purely wait through July unlesa new eonditions 
develop in Mexico ami if I keep well, perhaps even longer, so 
that you too may have a vacntion. I am so tired I can scarcely 
write. Was at the office all day yesterday and Sunday as 
well. 

Miss Delano ontlined the new work more definitely in a 
letter written on the seventh : 

Instructions for enrolled nurses as members of hospital 
units HhoLild be prepared. Outlines are needed for chief 
nurses who are to undertake the practical instruction of 
nurses' aides. 

Some method should be developed for the inspection of 
classes of instruction to women so that incapable instructors 
should not be allowed to continue. 

There will be a new course in Dietetics ready in the fall, 
whirh will make supervision more than ever necessary. 

I believe there Is a distinct menace to our nursing Btandards 
in the development of this lay per.nonnel unless it is carefully 
directed and supervised and that at this time no work in 
the entire country compares with it in far*reaching results or 
importance. 1 simply rannot do it alone hut will help in 
every way in my power and as 1 have said before, am perfectly 
willing as chairman of the National Committee to supiwrt 
you to the uttermost in any policy which you may think 
desirable. 

Miss Noyes came to Washington on June 13 to interview 
Miss Delano, Miss Boardmau and General Murray, then act- 
ing chairman of tiie Executive Committee, regarding the Red 
Cross appointment. On June 24 a short note from Miss Delano 
to Miss Noyes gives a seooud picture of National Headquarters: 




MOBILIZATION 



235 



You can imagine how busy we are and how interesting it 
is! We have jusl opened aiiotlier ofliec across Llie street 
(II and 17th] for volunteer workers, . . . They are address- 
ing eiivelopei* and Fending out hundreds of form letters. The 
Chicago Chapter has agreed to employ a nurse and New York 
is also ready. There is a tremendous piece of organization 
work to be done and your co-unlry lertainly needs you! 

I am trying to be patient, for I am sure you will do what 
is best, but you cannot know how many times a day I long for 
your tMX>l judgment and wise counsel. 

Miss Noyea accepted the directorship of the Bureau of Xurs- 
I iBg July 24 and came to Washington Sopttinkr 10, 2D1C, to 
dcTote her whole time and all her powers to the Ued Cross. 
A woman of clear judgment, of excellent organizing ability 
and jealously ambitious for her chosen profession, she "was 
wholly relied on by Miss Delano, with whoso more intense 
and dramatic nature the exceeding reserve of Miss Noyes was 
in striking contrast. Under the cckiI poise of her r>utwurd 
bearing there was a nai'vctc and warmth of pf^rsonality, only 
ipprcciated by those who knew her well. Like Miss Delano, ahe 
was tall and of commanding presence. Like her, too, her gray 
hair became snowy white during her Red Cross labors, 

LThe nursing staff now numbered five, not including the 
Rural iService. Besides Miss Delano, Miss Noyes, ^liss Reeves 
and Josephine Johnson, Katrina Hertzer, a member of the 
bvy Nurse C-orpa, who had served with Unit E at Budapest, 
na detailed on September 20, 1916, by the Bureau of ^ledi- 
ciDC and Surgery of the Department of the Navy to act as 
liaison officer between the Navy Nurse Corps and the Red 
CroBSf at that time organizing Navy base hospitals and detach- 
ments. Miss Hertzer was bom in Ohio and was a graduate of 
tke Illinois Trainiiog School for Nurses. Before her assign- 
ment by Surgeon General Braisted to the Red Cross, she had 
been superintendent of nurses of the City and ('ounty Hos- 
pital. St. Paul, Miuu., and chief uurse, U. S. Naval Hospital, 
Chelsea, Maaa. 

On the 26tli of January, 1917, the Red Cross Headtfuartera 
organization moved from its old locution to the beautiful build- 
ing on Seventeenth Street facing Potomac Park, which was 
erected aa a memorial to the *'Heroic Women of the Civil War'' 
and dedicated as tlie administration hcnd(intirtera in perpetuity 
of the American Red Cross. In common with the other de- 



236 HISTORY OF AMERICAN RED CROSS NURSING 



partments the Nursing Service bad completely outgrown its 
old quarters. 

Sin^ilarly appropriate is this Georgian-Colonial structure 
of Vermont marble, set opiK>8ite i\w. ellipse of the White House, 
the sf?cond in that line chain of buildJup* which extends down 
Seventeenth Street to the Tidal Basin. On its left is the 
Corcoran Gallery of Art ; on its right, Continental Memorial 
Hall, belonging to the Daughters of the Amerie^in Revolution, 
and just beyond that is the Pan-iVinerican lUiikling. Its 
history goes back to the Civil War, to two of Lincoln's volun- 
teers of 1861, Francis Barlow and James Scr^'mser. Sergeant 
(later General) Barlow was wounded at Antietam and again 
at Gettysburg. His wife, a member of the Sanitary Commis- 
sion, went to the battle line to nurse him, there contracted 
typhus and died, 18G4. To her husband, she typified the spirit 
of women in war time and in 1890, not long before his death, 
Major General Barlow prophetically said that some day the 
nation would build a fitting monument to the women of the 
Civil War. His friend, Captain Scrymser, heard his words and 
was afterwards one of the guarantors for the amount pledged 
for the building. The story of hnw the memorial was assured 
and built mav be read in Miss Boardman's book *'Under the 
Red Cross Flag." 

On the first floor to the left of the stairway Miss Delano 
and Miss Noyes shared tw^o spacious rooms, green-tinted, with 
books and photographs, soft-toned rugs and dark solid furni- 
ture, all in marked contrast to the starred oak desks and worn 
floors of the H Street oftiees. Miss Delano then matched her 
one wieker chair by others equally mrafortable. She often 
received contributions from friends who were interested in 
the Nursing Sen'i<'e and these went into a special fund for 
equipment, books, or other things connected with the welfare 
and comfort of Red Oross nurses. 

The volume of routine work of the Nursing Service at this 
time was outlined by Miss Delano in a letter written on 
August 31, 1916, to ^liss Boardman: 

The only thing that troubles me is the question of room 
in the new building and I am wonderin*; if by any chance it 
will he p08!5ible to have the small room whirh you had planned 
to ^ve to Miss Oliver for Miss Heeves and the nurse from the 
Nnvy if she comes. I shall have to put a part of the clerks 
in the room where the files are. We have two permanently 



MOBILIZATION 



23' 



for the f;Ias8 work and have been obliged to employ a third to 
help out with the additional work. It takes the time of one 
clerk for the surgical supplies and patterns, and ahouUl need 
a second clerk hut for the fact that we hnve been able to use 
volunteers in that office. It tak^^s the entire time of one clerk 
for the work of the batie hospital units und emergency de- 
tachments, with occasional help from others when the pres- 
sure of work comes in. Unlpss the work decreases more than 
I have reason to expect, I do not see how it will be possible 
to get on. We shall have more people, judging from present 
indications, than the top floor will accommodate. I am 
greatly worried and only wish you were here so that I could 
talk it over with you. 






To the third floor, nevertheleaa, went the Town aud Country 
Nursing Service, the clerical force, class instruction and the 
files of llic National Connnittce. The paraphernalia of surgical 
drvseiogs was ensc-onccd on the balcony overlooking the As- 
sembly Koom. Even this stately conference chamber hud been 
divided into offices, one of which Aliss Hertwr at one time 
occiipie«d. Temporary partitions shut otf the Tiffany memorial 
windows and stenographers from every corner of the United 
States tlocked dailv to their crowded desks there, while wait- 
ing for better locations. Though the Nursing Service retained 
two large offices on the first floor, the attaches and clerical 
in turn, moved from the attic to the basement, from the 
bsMznent to the First Annex, from the First Annex to the 
Third and finally brought up in lOlJ) in its present home in 
the permanent Fourth Annex, before its mushroom growth 
conid in* ac<H3mmodated. 

To aid Miss Noyes in the assignment of nurses and the stand- 
ardization of surgical dn'saiugs, Vushti Bartlett, of Johns 
Hopkins, came to National Headquarters in ifarch, 1!)17. Miss 
Bartlett had begun her Red Cross service during the Dayton 
flood; she was a member of Unit A at Pau, and of the Belgian 
tmita at La Panne. Her repl^' to Miss Noyes' request that she 
to Washington, brought a smile to the lips of the over- 
ed Director of Nxirsing. 

tVill jou answer a Alacedouian call?^' Miss Noyes bad 
..vd« 

"I will have to consult my family," replied Miss Bartlett, 
'^■fore undertaking further foreign service, especially in 
Qre^r 



oome 



238 HISTORY OF AMERICAN RED CROSS MUSING 



On April «, 1917, the United iStatPS cnten^J the World War. 
TmmediHtclv Red Cross HL'udqimrters was lliMided bv eorre- 
spoudciu'e. Stimulated by events, mirsea from all eoruera of 
the United States were vnlimteering. Iinineiise development 
took place in every branch of Red Cross work. On the 10th 
of ilay, 1U17, President Wilson had appointed a War Council 
for the American National Red Crass.' Their tirst task was to 
raise the vast sum of money needed. 

The personnel of the Nursing Service was now greatly en- 
larged. Anna W. Kerr, who had been one of Miss Delano's 
classmates, came to Washington to take over tlie examination 
of all applications for enrollment. Miss Kerr had been assist- 
ant at Bellc\Tie when Miss Dehmo had lx*en sujx*rintendent of 
nurses there. For eleven years she had been director of 
nurses of the Bureau of Child Hygiene, Department of Health, 
New York City. Her devotion and great faithfulness to Miss 
l)t?lano did not end with the death of her life-long friend. 

Agues O. Deans, well known to American nurses as a former 
aeeretary of the American Nurses' Association, came, on June 
11, 1J)17, to the office of the chairman of the National Com- 
mittee. Her knowledge of inirsing organizations and training 
schools thn>ughnut the country was of the utmost value to Miss 
Delano in the first Red Cross nursing survey. A graduate of 
the Farrand Training School for Nurses, Harper Hospital, 
Detroit, Michigan, Misa Deans was a pioneer public health 
nurse, having done visiting nursing in Midiigan ai»d Minne- 
sota, She was assistant to the director of the Department of 
Nursing nntil July 1, 1020; six months later, she became 
director of the Social Service Department, Wnshiiigton T^ni- 
versity, St. Louis. A devoted friend of Miss Delano, Misa 
Deans was an able executive and a loyal upholder of the best 
ideals of her profession. 

The organization of the base hospitals included a dietitian 
and her assistant. Public opinion in all parts of the nation 
demanded general instruction in the elementary principles 
of home dietetics and food eonser\'ation, of vital importance to 
a nation at war. Elva Anne George, a graduate of Pratt Insti- 
tute, came to the Bureau of Nursing on July 27, 1D17, to 

' Tlip originnl memltorR of tin? War Council wt're: FIcnry I*. Dnviaon. 
c-hnirraan: Charlen D. Norton, Mijor Graywn. M.-F*. Murphy, Cornelius 
N. BliHs, Jr.. and Edward N. Hurley, with WilHnin Hnwnrd Tnft, chair- 
man, and Eliot Wadsworth, vici.* ebairmon of the Ceiiiral Comuiiltee, ex- 
ofUciti. 




MOBILIZATION 



239 



I 



diarge of the mobilization of dietitians for the base boe- 
pitak and to supervise class instruction for women in the Red 
Cin»e» course of Home Dietetics. 

Helen Scott Ilay was the next nurse to join that strong grmip 

^ it by Miss Delano to National Headiiuarters. She and 

Itachel Torrance had had an eventful trip home from Bul- 
garia, following the declaration of war bv the United States. 
The organization of the base hospitals, which ealird for twenty- 
fire nurses' aides for each one, had given great impetus to the 
dtsa work in Klementarv Hygiene and Home Cnre of the Sick. 
Mias Noyes' duties in the selection and assignraeiit of nurses 
were tinihiplying to dimensions beyond tlie ixiiitrcJ of one in- 
dividual. Miss Hay accordingly came to Washington in July, 
1017, as director of the newly-^^reated Bureau of Instruction. 

In January, 1918, Miss Hay resigned from the Nursing 
Service to undertake at the request of the Surgeon General some 
special work for the Army Nurse Corps and Harriette Sheldon 
Douglas, a graduate of the Roosevelt Hospital, New York City, 
became director of the Bureau of Instruction. At this time, 
the Boope of this Bureau was broadened to include the assign- 
ment of nurses^ aides to foreign services and the name of the 
Bureau was enlarged to that of the Bureau of Nurses' Aides 
ind Instruetion. 

With Mias Douglas there came an interesting link with the 
Civil War days, for she was the daughter of the late Dr. John 
Hancock Douglas, attending physician during General Grant's 
]aj»t illness, who was also one of the thi*ee associate secretaries 
and Cbief of Inspection of the Sanitary Commission during 
the Civil War. Though she had not been engaged in active 
nursing for some years, Miss Douglas volunteered her services 
to the Red Cross in the early winter of 1917. Her appoint- 
ment to the Bureau of Nurses' Aides and Instruction was a 
particularly happy one, in that she combined tlie viewpoint of 
both the laywoman and the nurse. Slender and spirituelle, a 
flame of ardor in earnest eyes lit the view Miss Douglas had so 
ly of the humnn creature in every lonely and neglected pa- 
\t. Aa a sister of Bishop Harding of Washington, she was 
in a particularly fortunate position to bring to the support 

her work the interest and enthusiasm of many Washington 



, Minnigerodo (Bellevue) joined Miss Noyes' staff in 
Auguat, 1917, to take charge of the special units then being 



240 raSTORY OF AMERICAN RED CROSS NURSING 

organized for the War Department and for Red Cross foreign 
oommissions. She too had sailed on the Mercy Ship, serving 
in Kief; she too was intensely devoted to Miss Delano. She 
continued her Red Cross work until Deot^mber, 11118, when 
she undertook a supen'isory tour of the U. S. Public Health 
Hospitals, later becoming superintendent of nurses of the U. S. 
Public Health Service. Absolutely fearless, impulsive and out- 
spoken, devoted to her friends, resolute toward opponents, in 
Miss Miunigorode were found many attributes of the typical 
pioneer. 

The Town and Country Nursing Service had as its Director 
Fannie Clement uml latir Mary S. Gardner an4l Klizalwth 
Fox, An account of this Service and its leaders will be given 
in a subsequent chapter. 

Other nurses who assisted Miss Delano and Miss Noyes at 
National Headquarters at various periods during the war were 
Lyda Anderson, Florence Patterson, Virginia Ward, A. Maury 
Carter, Adeline U. Rowland (Mrs. Robert Gourlay), Josephine 
Johnson, Sarah Addison, Barbara Sandmaier, Lulu J. Justis, 
Charlotte Brewer, Adelaide Teunant, May Claypool, Charlotte 
Garrison, Elsbeth H. Vaughau and Marie Uodor. 

In that memorable summer of 1017, thousands of letters in- 
undated National Headquarters. Many were deeply touching 
in their genuine desire to help ; otiiers were full of war-hysteria ; 
some were shocking in their unconsciously displayed reversal 
to the frame of mind of the massed audiences at thrilling mo- 
ments of the gladiatorial combats of the (Coliseum: — all effer- 
vesced with "patriotism," One woman stated as her chief rea- 
son for volunteering that **her family had always taken an 
active part in disturbances of tlu* nation." Another wrote: 

Will you accept my services as an unprofessional nurse? I 
am a woman 35 years old, have a quiet disposition, a clean 
character and always keep my nerve under some very trying 
circumtjt^nces. I work every day on a milk wagon, so you 
sec I am strong and not lazy, 

A commenrial firm wrote: 

Kindly furnish us with lists of names and addresses of the 
nurses who are members of your orpinization. 

Upon receipt of your reply, we will be pleased to send you 
a full-sized bottle of our best grade of malted milk for your 
trouble. 




MOBILIZATION 



241 



The flood of letters had, indeed, begun even a year before, and 
was atenuned very largely at first by the steady work of volun- 
teers. Of the tirst staff of faithful volunteer helpers, Miss De- 
Uiu) had written : 

During the summer of 1916, there was such an enormous 
increase in the correspondence coming to the offire of the 
chairman of the National Committee on Red Cross Nursing 
Servit-^*. that it was found impossible to conduct the work 
without a great increase in the ofhce force. Beheving in the 
desirability of utilizing volunteer workers for Red Cross 
service, wtf asked for the assistants of various groups of women 
who had had our course of instruction in Elementary Hygiene 
and Home Care of the Sick and others interested in Red Cross 
work. 

Among the first to volunteer were Miss Joan Ohls and Mrs. 
Callan O'Laughlin, who came to us when the presHure of work 
was greatest, and helped us to conduct a mailing bureau 
through which thousands of letters and circulars were sent 
out. Both Miss Ohls and Mrs. 0*Laughlin came to the 
office daily through the greater part of the summer. 

Mrs. G. S. Meloy and Mrs. Richard Wetherill, of Lanlmm, 
liiryland, came regularly for several mouths, giving to the 
Bed Cross an entire day each week. They were of the greatest 
assistance, as they hel|>ed iji many details of ofliee work re- 
quiring a high degree of accuracy. They were assisted from 
time to time by Mrs. K. N. Wells, Mrs. Kdgar Brown, and 
Miss Cross, also of Lanliani. Maryland; the Misses Stewart, 
of Washington, D. C, and Miss Eugenie J. Cuthbert, of Chevy 
Chase, Maryland. 

Mrs. Robert Walcott Weekg devoted practically the entire 
summer to Red Cross work in the olltoe of the chairman of 
the National Committee on Red Cross Nursing Service, com- 
ing as regularly as any other member of the otEce staff, assist- 
ing in every way possible. 

The Misses Mahan, Haas, Lloyd, Hardy, Harvey and other 
enrolled Red Cros^J nurses came frequently as volunteers and 
Miss Lucy Minnigero<ie devoted her afternoons to Red Cross 
work, taking as her special task the sending out of appoint- 
ment cards and badges to enrolled Red Cross nurses. 

Volunteer secretaries of this calibre were regularly available 
through the crisis and many were called upon. 

By September, 1917, more than 5,000,000 people had been 
cnn.dJed as Rod Cross members; by December, there were 
22,000,000. Chapters, numbering 562 when war was declared, 



242 HISTORY OF AMERICAN RED CROSS NLTISING 



totaled 3,700 one year later, with n quota of 8,000,000 volun- 
teer workers, a mau-woinaii-aud-child power such as no other 
organization in the world t-ould claim. This brought, however, 
an intiuleuhible amount of detail to National Headquarters, 
which would have been entirely "swamped/* had not the War 
Council created the new organization i)hui called *\lecentraliza- 
tion, with Division ottices.'' National Headquarters had main- 
tained a branch office in New York City as early as 1912, the 
budget appropriations for which were contained in the Minutes 
of a meeting of the Executive Committee held Decmber 30 
of that yi'ar. As the need for Rod Cross disaster relief in- 
creased, the following action was taken by the Executive Com- 
mittee, meeting October 31, 1913: 

Jlr. Bickuell then preRpiite<l to the committee a suggested 
plan for tiie extension of the administrative efficiency of the 
Red Cross in organization and emergency relief. The plan, 
as outlined, iuvolved thu employment of four Divisiun di- 
rectors or superinteiideDts, to be stationed in each of the 
following points: San Francisco, Denver, Chicago and New 
York or Washington. . . . After some tliscuesion by members 
of the committee. General Torney moved that the tentative 
plan submitted by lilv. Bicknell be authorized. Motion sec- 
onded by Mr. Tanner and adopted.' 

When imperative need for greater administrative machinery 
arose in lt)l7, the new **decentralization plan" c*lalx>rated this 
principle through thirteen instead of four districts. It was 
described by Mr. Davison as follows: 



The word "decentralization" in this case resolved itself 
into the partitioning of the United States into thirteen di- 
visions, each division a smaller Red Cross, with all its depart- 
ments and bureaus under a divisional chief and a force com- 
plete in every detail with the various lines of endeavor firmly 
and clearly outlined. When once the foundation was com* 
plete, the War Council had no more to do with the Chapters 
or any of their aitivities, save in the way of judging the 
needs, devising methods and fixing standards. The Chapter's 
business wa.s regulated in tlie department to which it belonged 
by the divisional otficers. The Division manager was ... to 
his division what the general manager in Washington was 
to the entire organization. Waphington Headquarters was 
now free to proceed with the handling of the larger problems 
'Minutes of the Executive Committee, AmericKn Red CroM. page 368 



¥ 




MOBILIZATION 



24S 



» 



I 



which were daily growing to greater magnitude and impor- 
tance.' 

JS3 Delano and Miss Noycs appointed in each Division 
tmincnt nurses who handled all nursing details in their im- 
medinte states. Only vital questions of policy were referred 
to Nntionul Hcadquarlcrs, This group of ''Division Directors 
of Xursing," representing as it did strong women of recognized 
standing in their districts, comprised the very baeklM)ue of the 
Nursing Service. Through their hands passed all a[)|jrieutious 
for enrollment received from I>ocal Committees, jill inanage- 
mcnt of class instruction^ puLlic heulth nursing, early surveys 
and other details. On their shoulders rested the ultimate re- 
sponsibility of recruiting the many thousands of nurses requi- 
kiitioued by the Surgeon General. To tlieiu came, txx>, the well- 
nigh overwhelming demands for nurses for the influenza epi- 
demic. 
Hiss Delano outlined thus the relation of the nursing repre- 
itative to the Division manager and the Bureau of .Nursing 
at National Headquarters: 

As the success of the Nursing Service and our ability to 
»4*cure the nurses in the large number likely to be needed 
during the period of the war depends entirely upon main- 
taining the interest and enthusiasm of the graduate nurses 
throughout the country, it seems to me of primary importance 
that the pv*rson in charge of the Division Bureau of Nursing 
Service should be a Ked Cross nurse and should be in truth 
the representative of the Nursing Service. She should be 
appointed by the chairman of the National Committee on 
Ked Cross Nursing Service, subject, of course, to the ap- 
proval of the Division manager. 

Furthermore, since the direction of all the activities of the 
Bureau of Nursing Service within the jurisdiction of the 
Division will be in charge of this person, it is highly important 
that we secure the services of nurscn who, by reason of their 
education, experience, professional standing, executive ability 
and knowledge of comlitions in the Division, will be highly 
qualified to fill these iinjxjrtant positions. I believe tliat tliis 
ortice, through the national organization of nurses^ is best 
prepared to secure the qualified personnel. 

AM professional phases of the work of the Division Director 
of the Nursing Service should be suhject to the direction 

•"Thr Amerirun Red CrosB in the Grt'ai War/' pages 10-17. The 
MacmilUn Company, 1010. 



244. HISTORY OF AMERICAN RED CROSS NURSING 



of tlie Bureau of Nursing Service at National Headquarters, 
for only in this way will it be possible to maintain the neees- 
Bory standards and uniform policies of the Red Cross Nursing 
Service. 

It will he necessary for the Division Director of the Nursing 
Service, in administering her Bureau, either personally or 
through her functional assistants, depending upon the extent 
of the activities in her Division, to: 

(1) Supervise Chapter work as related to nursing activitiea 
and advise Chapters on matters of policy and practice pertain- 
ing to nursing service as prescribed by National Headquar- 
ters. 

(2) Supervise instruction of personnel within her Division 
and cooperate with Chapters and committees on Red Cross 
Nursing Service on matters relating to enrollment of in- 
structors. 

(3) Supervise the organization and administration of 
Chapter instruction in Klpmentnry Hygiene and Home Care 
of tlie Sick and in Home Dietetics. 

(4) Advise and cooperate with Chapters on matters relat- 
ing to class equipment. 

(5) Study and advise on methods of promoting enroll- 
ment in classes. 

(0) ('ooperate with Local and State Committees on Nurs- 
ing Service in promoting enrollment of Red Cross nurses. 

(7) Summarize periodic reports relating to activities un- 
der the Nursing Service as received from Chapters and 
compile Division reports of these activitie-s for the Division 
manager to transmit to National Headquarters. 

(8) Perform such other ijuties as may be designated by the 
Bureau of Nursing Service at National Headquarters. 

In the December, 11)17, issue of the Journal, Miss Delano 
reported the appointment in October of these Division represen- 
tatives. Elizabeth Ross, a graduate of the Newton Hospital, 
and a public health nurse of high standing, served in the New 
England Division, which inchidcd Maine, New Hampshire, 
Vermont, Massachusetts and lUiodt^ Island. Miss Ross had 
organized the Nursing Center of the Woman's Municipal 
League of Boston and had also acted as supervisor of the Nor- 
wood Civic Association. 

Carolyn C. Van Blarcom (Johns Hopkins) resigned as secre- 
tary of the Illinois Society for the Prevention of Blindness to 
represent the Nursing Service in the Atlantic Division, wfaicii 
included New York, Connecticut and New Jersey (except 



MOBILIZATION 



245 



Caznden). Of Dutch descent, she was possessed of keen organiz- 
ing ability and of brilliunt processes of thought and expression. 
At varying periods of her useful career, sbe was assistaut super- 
intendent of nurses at her alma mater, then superintendent 
of nurses, St. Luke's Hospital^ St. Louis, superintendent of 
the New Bedford Tuberculosis Sanatorium and secretary of 
the National Committee for the Prevention of Blindness. Upon 
her arrival in June, 1917, at Atlantic Division Ileadquarters, 
New York City, she immediately set up the organization of a 
nnrsee' equipment division for the base hospitals then embark- 
ing for France and to her acumen was largely due the establish- 
ment of the efficient system which characterized this important 
detail of mobilization for foreign service. Another couapicu- 
ous piece of her work was the recruiting of hundreds *)f Red 
CrosB and Army nurses then in New York who marched in 
the historic first Red Cross parade of the uutunin of 1!H7. 
During the later part of that year. Miss Van Blarcora under- 
took a speaking tour of the United States to interest nurses in 
enrolling for war service, after which ill health necessitated her 
resignation from Red Cross service. 

Florence Merriam Johnson followed Miss Van Blarcom in 
January, 1918, as director of nursing of the Atlantic Division. 
A graduate of Smith College and of the New York Hospital, 
she had been connected with the Cornell University Medical 
Dispensary, New York ; had done social service work for the 
New York Association for the Improvement of the Condition 
of the Poor; and for the Harlem Hospital. She later became 
a member of the faculty of the Department of Nursing and 
Health, Teachers College, Columbia University. Her remark- 
able service in facilitating the embarkation and drlmrkatiou 
of nursea in foreign service brought her the Florence Nightin- 
gale Medal of the luteruational iied Cross. A woman of poise, 
intelligence and great charm, she combined sympathetic 
warmth of personality with firm executive ability to such an 
extent as to make her one of the most capable and well-loved 
nuraed of the "younger generation" wbicli the war brought 
forward. 

The Pennsylvania Division, which included the Keystone 
State, Delaware, and Camden, New Jersey, was represented 
by Susan Francis (Reading Hospital, Penus;ylvania). She was 
long associated with state organization work and with early 
R«i Cross Nursing Service projects. Miss Francis had been 



246 HISTORY OF AMERICAN RED CROSS NURSING 

superintendent of nurses of liospitals in the City of Wushiug- 
tou, in New Orleans, and in Philadelphia. 

Georgia Marquis Nevins came to the Potomac Divison (Dia-^ 
trict of Columbia, Maryland, Virginia and West Virginia) af- 
ter twenty-three years of service as the head of Garfield Memo- 
rial lioapital, Washington. Her name has appeared more than 
once since an early point in our text, in connection with profes- 
sional progress and growth. She was one of the first class 
graduated under Miss Hampton at the Johns Hopkins. An 
ardent sponsor of the Army Nurse Corps and also of the bill 
for registration of nurses in the District of Cohmibia, she was 
at one time president of the National Leag\ic for Nursing Edu- 
cation, then known as the American Society of Superinten- 
dents, and for many years was secretary of the American 
Nurses' Association. Her Red Cross service began in 1900, 
as secretary of the National Committee on Red Cross Nursing 
Serrice. A New England woman, she represented a type of all 

the sturdv virtues of that section. 

» 

Jane Van de Vrede (Milwaukee County Hospital, Wauwa- 
tosa, Wisconsin) was the nursing representative for North and 
Soutli Carolina, Florida, Georgia and Tennessee. Miss Van 
de Vrede was for nine years assistant bacteriologist of the 
Department of Health, Savannah, (iti^rfria. .As secretary of 
the State Board of Examiners of Nurses for Gt»c>rgia, and as 
vic4? chairman of the Savannah Red Cross Chapter, and s<>cre- 
tnry of the Local CVimmittcc on Red Cross Nursing Service of 
that city, she brought to her duties a wide, extremely practical 
knowledge of southern nursing resources. 

The Gulf Division, to which L. Agnes Daspit (Touro Infir- 
mary, New Orleans) was appointed, included Alabama, Mis- 
sissippi and Ix>ui8iana. Miss Daspit had long been associated 
with the Red Cross Nursing Service, as chairman of the Loui- 
siana State and Ix>cal (\)mmittees. She was at one time 
president of the I-ouisiana State Nurses' Association and chair- 
man of the Advisory Board of the State Bf>ard of Examiners, 

The Southwestern Division, covering the immense distance 
of Texas, Alissouri, Kansas, Arkansas and Oklahoma, was for- 
tunate in securing so able and tireless an organizer as Lvda 
W. Anderson, already known to readers of this history as sui>er' 
visor of Unit K of the Mercy Ship. 

Mary M. Roberts (.Jewish Hospital, Cincinnati) ser%'ed as 
nursing representative in the Lake Division, embracing Ohio, 




MOBILIZATION 



2*7 



?i 



I 



and Kentucky. Both as auperintcndent of nurses 
in tho Savannah Hospital, and assistant superintendent of 
nurses of the Jewish Hospital in Cincinnati, she had had long 
experience in admiuistrutive work. As a former president of 
the Ohio State Association of Graduate Nurses and a member 
of the State Board of Nurse Examiners, she too was excellently 
fitted for the tasks before her. 

A child 'welfare nurse of national reputation, Minnie H. 
Ahrens (Illinois Training School for Nurses; Teachers Col- 
lege* directed Red Cross activities in Illinois, Wisconsin, Iowa, 
Nebraska and Michigan, the states comprising tlie Central 
Division. Though Miss Ahrens* name had been long asso- 
ciated with high standards of nursing education, she was per- 
haps Ixjst known as an organizer and the first super in teudeut 
of the Infant Welfare Society, of Chicago. 

The Northern Division, Minnesota, North and South Da- 
kota and Montana had as its nursing representative Edith A. 
Barber. A graduate of the Garfield Park Hospital, Chicago, 
Miss Barber was at one time superintendent of nurses of the 
Green Gabies Sanatorium, Lincoln, Nebraska, and a member 
of the training school staff of the University of Minnesota. 

I^ttie 0, Welch (Illinois Training School) was appointed 
to the Mountain Division including Colorado, Wyoming, New 
Mexico and Utah. Formerly superintendent of nurses of the 
City and (*ounty Hospital, Denver, she had served for several 
rears on the Colorado State Committee on Red Cross Nursing 

Lillian L, White (Protestant Episcopal Hospital, Philadel- 
phia), also long assoeiatcd with nursing education, gave up her 
position as assistaut superink'udcnt of luirses of the Univer- 
sity of California, to reprcsiMit the Red Cross Nursing Service 
in the Pacific Division, embrHcing Nevada, Arizona and Cali- 
fornia. Miss White had at various p(»riodfl of her career been 
gnperinfendcnt of nurses of the Knoxville (Tennessee) Gen- 
eral Hospital; of the ^lerritt Hospital, Oakland, California, 
and head of tbe Baby Hospital of that city. 

Including Washington, Idaho, Oregon and Alaska, the 
Northwestern Division had as its nursing representative May 
S. T»oniis (Illinois Training School). She was a surgical 
nurse of long experience. Chairman of the Washington State 
oommitt^^ on Red Cross Nursing Service since 1915, she gave 
np her position as supen'isor of nurses at the City Hospital^ 



248 HISTORY OF AMERICAN RED CROSS NURSING 



Seattle, to accept the Red Cross appoiutment. Miss Loomis 
was for several years president of the Washington State Nursea' 
Association. 

Following the establishment of the Divisions, the Executive 
Coniniittee voted on Dfccniber 0, 1917, to create the Depart- 
ment of Nursing, combining under one executive all phases 
of the nursing program. Miss Delano became the diretrtor, her 
vision of a lightened responsibility and a country home relin- 
quished for the time, and the representatives in the Division 
offices were given the title of Division Directors of tlio Depart- 
ment of Nursing, This organization was put into effect in the 
spring of 1918, Miss Nojes, who had lM*en on a speaking 
tour since Decemb«^r, 1017, returned to National Headquarters 
in February, liJl8, and became director of the newly created 
Bureau of Field Nursing, through which the selection and as- 
signment of all nurses for war duty, either military or civilian, 
were carried out Some of the changes then occurring have al- 
ready been mentioned. The reorganization of the Town and 
Country Nursing Service will be spoken of under its own 
chapter heading. 

With the National Committee on Red Cross Nursing Ser- 
vice acting in an advisory capacity, with the strong Head- 
quarters' orgnnizatiou ut Washington and with corresponding 
Departments in all Divisions, the Red Cross Nursing Service 
now faced the greatest nursing needs of American and world 
history. From its inception in the scattered efforts of the Civil 
and Spanish-Anierican wiira, its jMniee time di^velopment from 
1!)09 to 1017, one step toward more complete organization hnd 
followed fast on the heels of anotlu^r, until the creation of the 
Department of Nursing marked the final perfection of this 
great "inaehine," so efticient atul withal so silent and unobtru- 
sive, that few indeed realize how vital and far-reaching were 
ita workings and how great its results in the alleviation of hu- 
man suffering. 

The National Committee on Red Cross Nursing Service 
guided the |)<>Iicie8 of development of American Red Cross 
nursing service. The members of the National Committee 
who served at the outbreak of the war were Jane A. Delano, 
chili mmn : William C. Gorgas, Surgeon General of the Army; 
W. C. Brnisted, Surgeon General of the Navy; Rupert Blue, 
Surgeon General of the Public Health Service; Annie Good- 
rich, preeidentj American Nurses' Association ; S, Lillian Clay- 



MOBILIZATION 



249 



president, National T-oague for Nursing Education; Mary 
F. Beard, president. Xatioiml Orj^anization for Public Health 
Nursing; Colonel Jelferson R, Kean, Director of Military Re- 
lief, American Red Cross; W. Frank Pereons, Director of 
Civilian Relief, American Red Cross; Major C. H. Connor, 
Director, Bureau of Medical Service, American Red Cross; 
Dr. T. W. Richards, Director, Bureau of Naval Service, Ameri- 
can Red Cross; Clara D. Noyea, Director, Bureau of Nursing 
Service*, American Red Cross; Fannie F. Clement, Director, 
Bureau of Town and (^ountry Nursing Service, American 
Bed Cross; Emma H. Ounther, chairman. Committee on Dieti- 
tuns; (appointed for tliree years) Alabel T. Boardninn ; 
Mrs. Wm. K, Draper, New York City; Mrs. Wm. Church 
Osborne, New York City; Anna C. Maxwell, Presbyterian 
Hospital, New York City; Mary E. Gladwin, Akron, Ohio; 
Mrs. Frederick M. Tice, Chicago; Lillian D. Wald, New Yurk 
City; M. Adelaide Nutting, New York City; Amy Hilliard, 
Bellevue Hospital, New l^ork City; Susan C. Francis, Phila- 
delphia; Ix)uise M. Powell, New York City; Jane E. Nash, 
Baltimore; (app<^iinted for two years) Julia Stimson, St. 
Louis ; Emma Nieliols, Boston City Hospital ; Dora E. Thorap- 
Bon^ head of Army Nurse Corps; Lenah S. Iligbee, head of 
Navy Nurse Corps; Ella Phillips Crandall, New York City; 
Get>rgia M. Nevius; Anna L. Reutiiiger, New York City; Eliz- 
abeth G. Fox, Visiting Nurses' Association, Washington; Har- 
riet Leet^, Cleveland, Ohio; Anne II. Strong; Simmons College, 
Boston; (ap|X)inted for one year) Alnui E. Wriglev. Pasadena, 
CaL; Carrie M. Hall, Peter Bent Brighani Hospital, Boston; 
Lucia Jacquith, Memorial Hospital, Worcester, Mass.; Anna C. 
Jamnie, State Board of Health, Sacramento, Calif.; Menia S. 
Tyc, Sparks Memorial Hospitjil, Ft. Smith, Ark. ; Emma L. 
Wall, New Orleans, La.; Mathild Krueger, Menomonie, Wis.; 
Aj^ea G. Deans, Detroit, Mich.; Ethel S. Parsons, Division of 
Health, San Antonio, Texas; Mary C. Wheeler. Illinois Train- 
ing School, Chicago. Duties of the committee were: 

1. To organize and sapervisc the Nursing Service of the 
American Hcd Cross, and t(» et^tablish uniform standards for 
the onrnllment of nurses, tlietitians and other persormel needed 
for the nursing activities of the American Red Cross, 

2. To secure annually from the American Nurses' .Vsftooia- 
tion, the National League for Nursing Education and the 
National Organization for Puhlic Health Nursing, nomina- 



250 HISTORY OF AMERICAN RED CROSS NURSING 



tions to fill vacancies as they occur in the Xational Committoe 
on Nursing Service aud to submit these nominations with 
recommendations to the Central Committee for appointment. 

3. To appoint, annually, State Comraittces on lied Crosa 
Nursint^ Service, of not leBs thau six members, who are en- 
rolled Hed Cross nurses from names submitted Ly the execu- 
tive committee of State Nurges' Associations. When possible, 
the nurses selected should consist not only of members of the 
American Nurses' Association, but of training school 
BUperinteodents and public health Nurses. In order that 
the work of committees may not be interrupted, a complete 
change should l>c avoided. 

4. To appoint such committees, not otherwise provided 
for, as may be necessary to supplement tlie work of the Na- 
tional Committee, and to specify the duties of all cumjiiitteea, 

6. To issue the necessary instructions, circulars of infor- 
mation and blank forms of application for (he enrollment of 
the I^ed Cross personnel of women, 

G. To appoint local headquarters recommended by Local 
Committees where lists of enrolled nurses and other person- 
nel may be kept on file. Such headquarters should be pre- 
ferably registries for nurses, or training school offices. 

7. To pass upon all applications for enrollment forwarded 
to Red Cross Headquarters and to issue cards of appointment 
and Ked Cross badges or pendants to nurses meeting the re- 
quirements, to issue cards of appointment to approved dieti- 
tians and to annul the appointment of any member of the 
Nursing Service for causes which it may deem sufficient. 

8. To keep a card catalogue of all committees and of local 
nursing headquarters with a list of all nurses and other 
personnel on file with each. 

9. To keep on file lists of Sisterhoods and other orders, and 
women volunteers available for Red Cross relief work in- 
volving the care of the .sick or wounded, either in time of 
war or calamity, the names of Red Cross nurses employed by 
chapters, other Red CVoss organizations or those authorized 
to use the Red Cross insignia, together with the names of 
members of the Army and Navy Nurse Corps who are also 
enrolled Red Cross nurses and to refer the latter to Local 
Committees when their term of service expires. 

10. To provide, in cooperation with the medical depart- 
ments of the Army and Navy, instruction for enrolled nurses 
in such special duties as would be required of them in time 
of war. 

11. To adopt courses of instruction for women other than 
nurues. which will aid in the care of the sick in their own 



MOBILIZATION 



251 



homes nnd prepare them to render assiatance, as required 
under the supervieiou of the Nursing Service of the Red 
Cross. 

12. To study the Nursing Service of the Kcd Cross in this 
and other countries; to report on the efficiency and needs of 
our own Hervices and make such recommendations to the 
Central Committee as tlie exigencies of the service may 
indicate. 

13. To advice concerning the administration of the Town 
and Country Nursing Service, to interest nurses in this phase 
of Ked Cross work, and to aid in securing oppitrtiinitics for 
the special preparation nec-essaTy to qualify for Hed Cross 
Service aa public health nurses. 

14. To make recommendations to t!ie Central Committee 
of the American Hed Cross in regard to the selection of Di- 
rectors of Bureaus of the Nursing Service, and other nurses 
employed at Ked Cross Headquarters. 

15. To share with the Directors of Nursing Bureaus the 
responsibility for the assignment to duty and supervision of 
all personnel included in tiie Red Cross Nursing Service, 



Details of the time of annual meeting and other routine 
matters completed the schedule. The duties of State Com- 
mittees were thus dedned: 



IG. State Committees consist of not less than seven mem- 
l)€rs, appointed by the National Committee, from names sub- 
mitted by the exociitive couunittec of State Nurses' As- 
R>ciatious ut the time of their annual meeting, such members 
to be enrolled Red Cross nurses. 

17. To appoint annually such Local (Committees on Red 
Cross Nursing Service as may be needed for the enrollment of 
nurses in their own state and to designate the chairman of 
each committee. . . . 

19. To have general supervision over Local Committees and 
to stimulate interest in the Red Cross Nursing Service. 

20. To report all Local Committees appointed, and 
vacancies filled, to the chairman of the Nntional Cummittcc. 
giving the names and addresses f>f nil members, and indicating 
the chairnifln and secretary of each Committee. 

21. [This clause dealt with meetings and reports.] 

?2. State Nurses* Associations organized for the enrollment 
of Red Cross nurses are members of the Amcricau Red Cross 
and entitled to be represented by one delegate at the Annual 
Meeting of the Red Cross. 

It is desirable that tlie delegate selected should be a mem- 




252 HISTORY OF AMERICAN RED CROSS NURSING 



ber of the State or a Local Commiltec ou Red Cross Narsiug 
Service. 

Local Comraittpcs consist of at least six nurses appointed 
by State Committees on Red CroPS Nursing Service, 

The duties of Local Committees on Red Cross Nursing Ser- 
vice were: 

23. To make rpconiincniluiinii to the National Committee 
as to the apj>ointnu'nL nf hi^rtdquarters. whore a list of enrolled 
nurses and other persctnnel of the Nursing Senice may be 
kept on file, sudi headquarters to he preferably registries for 
nurses or training school offices, as it is important that a 
place should he schn-tcd whore nurses may be secured at all 
times day and night. 

24. To issue circulars of information and blank forms for 
enrollment to apjiltcujits, and to decide whether applicants 
fulfill the requirements and are desirable. 

25. To rd'cive applications f(ir the enrollment of nurses 
and to secure tlie required credentials except from nurses 
interesteij in the Town and Country Nursing Ser%'ice. whose 
applications should be forwarded direct to Red Cross Head- 
quarters, Wafihington, D, C, where credentials will be se- 
cured.* 

Of the numbers and activit;^' of the Committee* Miss Delano 
said, in tlie Aonual Report for the year ending December 31, 
1917: 

In addition to the National Committee, we have forty- 
eight State Committees and one hundred and two Loral 
Committees on Red Cross Nursing Service, four State and 
thirty-four I^ocal (^omraittees having been apfKiinted since 
January 1, 1917. About one thousand nurses are serWng the 
Red Cross gratuitously on these committees. 

After the war she wrote of the work of the State and LocaI 
Committees : 

To the State Committees on Bed Cross Nursing Service, 
and the Local Committees representing local nursing organi- 
zations, the Nursing Service of the Red Cross owes much 
during the past years. The large enrollment of Red Cross 
nurses was due in a great part to the aitivitiea of these com- 
mittees. Approximately one thousand graduate nurses are 
serving gratuitously aa members of State and Local Com- 
•A. R. C. 150. July 12. 1917. 



1 



4 



MOBILIZATION 



253 



»s on Rod Cross Kureing Service, and the value of their 
s^ervifes cannot be overestimated, Diirinj; the jieriad of the 
war. these committees hehl frequent meetings to pass on the 
a[>j>lication of tlioutandtj of nurses and t^aiTificeil tfieir 
vacations, and often their positions, in onler to do this vol- 
unteer work of the Red Cross. When the need for nurses 
for active service became pressing, during the period of the 
war, the Nursing Service of the Red Cross appointed on its 
Local Committees those women especially who were unable 
to accept active service, but who had given generously of their 
time and money to eurry on this important part, of the Red 
Cross work. These Local Committees in this way prepared 
thousands of nurses for active service; advised them in regard 
to their home conditions and their release from positions; and 
it was only through their cooperation and assistance that the 
work at National Headquarters was made possible. 

The size of the National Committee on Red Cross Nursing 
Servit.*c and the widely-separated locations of its members made 
it imperative to have a small but efficient Executive Committee. 
Organized July 23, 1017, this was composed of any members 
then stationed in Washington, with the presidents of the three 
national societies of nurses. This small eomniittoc shared 
ihe rt*sponsibi!ity of the problems of the Ked Cross Nursing 
Sendee as they arose day by day. 

Soon after the appointment of the War Council by Presi- 
dent Wilson on May 10, li)17, its chairman, Mr. Henry P. 
Davison, arranged special conferences designed to bring the 
different Red (Vosa Departments together to consider nursing 
problems and to make recommendations in regard to the Ser- 
ricc^ On this committee there were representatives of the 
War Council; the Red Cross Committee on Cooperation; the 
Ri»d Cross Medical Advisory Committee; and the National 
Committee on Red Cross Nursing Service. Dr. Sinum Flexner, 
Chairman of the Red Cross Medical Advisory (Virninittets pre- 
sided at a meeting of this conference which was held at Head- 
quarters, July 23, 1917. A nuralw^r of mrmbera of the Na- 
tional Committee on Nursing Service hud been invited to 
•nd. Those present were: (from the Rt^d CVoas National 

»mmittee on Nursing Service) Miss Delano, chairman; Miss 
Noyes, Director, Bureau of Nursing Service; Miss Clement, 
Director, Bureau of Town and Country Nursing Service; Miss 
Hay, Director, Bureau of Instruction for Women; Miss 
Deans; Mrs. William K. Draper; Miss Nutting; Miss Good- 



254 HISTORY OF AMERICAN RED CROSS NURSING 

rich; Miss Beard; Miss Clayton; Miss Wald; Miss Hilliard; 
Miss Thoiopaon; Mrs. Higbec; (from the liod Cross Com- 
mittee on Cooppration) Judge? K(»bt?rt S. Lovett; Messrs. 
A. I). Hodonpyl, (Jcorge Wharton Prpper, Kdwjird I). 
Butler, John F. Moore, and L. K. Frankel ; { from the lied 
Cross Medical Advisory Committee) Doctors Biggs, Chapin, 
Flexner, Kerr, Rose, llyan, Rosenau, Smith, Pearce and 
Richards; (from the War Council) Messrs. Davison and Wads-' 
worth. 

The entire field of nursing needs and desirable standards of 
nursing qualifications for Red Cross war enrollment was thor- 
oughly gone over. It was agreed that there was no immediate 
shortage in well-trained nurses and that the Red Cmss was 
adding to its available reserves in every way that foresight 
could dictate. It was found that the real crisis of the nursing 
situation lay iii the future and that while present needs were 
biMUg met tlie war deiiumds would increase rapidly and it was. 
of the greatest importance that well edu(.'ated women should- 
be urged to take the nurse's training. At the end of the con- 
ference the chainnan (Dr. Flexner) was dire<*ted to api>oiut 
a small conference committee to meet on a later duv in that 
same wifk and settle finally, if possible, the war nursingj 
policy of the Red Cross in regard to the standards for enrolkT 
inent and to report its conclusions to the War Council. 

Dr, Flexner appointed iliss Delano, iliss Nutting, Misa 
Beard, Dr. William II. Welch, Dr. Ucrman M. Biggs and 
Dr. Winford IT. Smith. 

On Friday, July 27, all except Dr. Welch and Dr. Biggs who 
were unable to be present, met at Red Cross Headquarters, 
Dr. Flexner took the chair and Dr. R. M. Pearce (of the 
Medical Advisory Committee) acted as secretary. The con- 
ference committee examined its nursing problems in a frank 
and thorough-going way and in due time its report was laid 
before the War Council and accepted by that body. The quea- 
tiona considered were: 



1. Size of hospitals in which nurses arc trained, i.e., aver- 
age number of patients per day. 

2. A^e limit at the lime of enrollment. 

3. Early graduation of classes in (a) three year, (b) two 
year schools. 

4. Short training courses fur aides. tj 




MOBILIZATION 



256 



5, Public health nurses — shoiilrl they be urged to decline 
service with hoiipital units abroad? 

1. Hospital training gchooU. 

The committee discussed first the Red Cross re<^uirements 
for enrollment in its nursing service with such modilicationa 
&6 have been found necessary to meet war conditions. The 
chairman of the National Committee on Hed Cross Nursing 
Service reported that in cooperation with iState Koards of 
Registration provision has been made for the acceptance of 
graduates from schools recommended hy the Boards as giving 
sufficiently thorough training to qualify puch graduates for 
War Service. This modification has been mnile, she reported, 
without a definite requirement as to the size of the hospital. 
It is estimated that ap>proximately five hundred training 
schools will be added to tlie acceptable list through this 
dunge. 

2. Age limit of enrolling nurses. 

The chairman of the National Committee on Red Cross 
Nursing Service also rejKtrti'd that tlie age limit for enrolling 
nurses has been reduced to twenty-one years and extended 
beyond forty years, depending upon the qualifications of the 
individual nurse in each case. 

3. Early graduation of nurses. 

Tlie quesjtion of an earlier graduation of the pupils already 
in training in orrl^r to increase the supply of nurses, was 
discussed. It was tlie opinion of t!ie .^pocijil committee that 
flchooJfi giving a three year course of training might later, 
should the exigencies of war make such action necessary, be 
requested to advance the date of graduation. 

Miss Nutting submitted a report of the i*(Tort8 now being 
made by the Committee on Nurt^ing of the Council of Na- 
tional Defense to increase the output of the training schools. 
In I'ooperation with the Hed Cross it has addressed an appeal 
to college women and to graduates of tcthnical s^chools. high 
and private schools, urging them to enter training schools as 
student nurses in training, and thus aid in meeting the need 
of civil hospitals as well as supply a large body of women of 
exceptional ability trained for the reconstruction work which 
will follow the war. 

The chairman of the National Committee on Red Cross 
Nursing Service reported that provision lias been made for a 
complete listing of the nursing Sisterhoods throughout the 
I'nited States. A questittnnnire is to be sent to tlie.^e Sister- 
hoods to determine the approximate number of nursing Sis- 



256 HISTORY OF AMERICAN RED CROSS NURSING 



tera and lay Sisters trained in their hospitals who are available 
for Red Cross pervife. ProviHion has also hoen made to utilize 
colored nurses for service in caring for colored troops in base 
hospitals and the Ked Ooss will enroll such nurses as needed. 
It was also reported that the Hed Cross has organized com- 
mittees for the enrollment of nurses in Hawaii* the Philip- 
pines and in France, in order to utilize American nurses resi- 
dent in those regions, 

4. Training of nurses' aides. 

The system of training nurses' aides was considered. The 
chairman of the National Coinmittee on Red Cross Nursing 
Service reported that authority has already been given to 
forty-Gve hospitiil centers aruuutl whkli base hospitals have 
been organized to provide practical hospital experience to 
women volunteering as nurses' aides. These hospitals will be 
urge<l to complete their litiis of twenty-five aides each on first 
call* and to carry a reserve of twenty-five or more. This will 
give approximately twenty-two hundred and fifty aides avail- 
able for service. 

A questionnaire is being prepared to send to these vol- 
tinteers in order to determine how many of them are ready 
for service, in either the military or civil hospitals in this 
countrj'. The course in Elementary Hygiene and Home Care 
of the Sick forms the basis of selection for admission to this 
service, and some idea of the possible resources may be gained 
from the fact that about thirty-four thousand women have 
completed this course of instruction. 

6. Public health nurses. 

The question of utilizing public health nurses for aervice 
both in this country and abroad was considered. The chair- 
man of the National Committee on Ked Cros* Nursing Servi<* 
reported that in order to utilize public health nurses to the 
best advantage a special enrollment has been provided exempt- 
ing them from otlier servic<». Under this enrollment public 
health nurses will be held available for service in and about 
military cantonments in this country and for service in activi- 
ties in Europe. 

Summary. 

In submitting the foregoing report, the Special Commit- 
tee on Nursing appointed by the Red Cross War Council 
desires to express its approval of the general plan of enroll- 
ment of nurses as adopted by the National Committee on Red 
Cross Nursing Service. The mndifi(^tiona included in this 
plan may be summarized as follows : 



1 
i 





MOBILIZATION 



1. That the Iowot age limit for Rwl Crofis niirseg be reduced 
to twenty-one years; that the upper age limit be left in- 
definite, to be dealt with Peparately in each case according to 
the character of the service and the physical qualiBcations of 
the applicant 

2. That the requirements governing training schools be 
modified i*o aH to qualify for Hed Cross enrollment the grad- 
uates of schools which are recommended by State Boards of 
Bcgietration && giving course*) 8uf1nciently thorough to pre- 
pare nurses for Red Cross service. 

3. That in order further to increase the supply of nurses, 
the schools giving a three year course of training be re- 
quested to advance the date of graduation of pupil nurses, 
should the exigencies of war make such action seem desir- 
able. 

4. That in addition to the steps already taken to supply 
volunteer nurses' aides, which the committee npproves. it is 
recommended that the period of practical hospital experience 
for these volunteers be increased to one month of eight hours* 
service each day under the supervision of the Ked Cross, and 
that the Red Cross volunteer aides be used for service in our 
own country only, and that women under twenty-one years 
of Age shall not he selected. 

In view of the provision already made for the instruction 
of volunteer aide-S in connection with Base Hospitals and the 
large number of women who have completed the required 
course of theoretical instruction and whose names are on file 
in Washington, the committee believes that the immediate 
extension of this service is not pressing, but approves of the 
anthorization of civil hospitals to give this instruction to 
nurses' aides as needed. Fuhject to the approval and under 
the direction of the American Red Cross, and recommends 
that only those hospitals approved by the State Boards of 
Hegistration of Nurses shall receive such authorization. 

5. The committee approves of the plan adopted by the 
National Committee on Red Cross nursing for a special en- 
rollment of public health nurses who shall be hehl available 
for public health work under the Red Cross either in this 
country or abroad. 

This program has been approved by the oflicers of the Red 
Cross Nursing Sen'ice ; by officers of the Committee on Nurs- 
ing of the Council of National Defense; by Annie Goodrich, 
president of the American Nurges' Association ; Mary F. 
Beard, president of the National Oi^myj^tion for Public 




258 HISTORY OF AMERICAN RED CROSS NURSING 



Health Nursing; S, Lillian Clayton, president of the National 
Lea^e for Nurse Education; Amy Hilliard, formerly in- 
spector of training Bchools in New York State ; Dora E. 
Thompson, superintendent of the Army Nurse Corps; Leimh 
S. Higbee, superintendent of tho Nnvy Nurse Corps nnd by 
the Red Cross Medical Advisory Committee and the Bed 
Cross Committee on Cooperation, 

The mfmlx-ra of the R(^d Cross dcpHrtmrnta wrrp i^rntiflrd 
by this ondorsfmont and bv tho letter that had been written a 
little earlier bv Miss Nutting, here rcprtiduecd, for the anxiety 
nnd responsibility of exeeutive work often formed nn almost 
cnishing burden for Miss Delano and her oo-workers, who, de- 
sirous on one hand of maintaining high professional require- 
ments, were on the other under the obligation of meeting every 
instant necessity in the matter of a supply of nurses, no matter 
bow difficult 

Teachers College, 
Columbia University, 

July 16, 1917. 
Miss Jane A. Delano, Chairman, 
National Committee on Red Cross Nursing Service, 
Washington, D. C. 

My dear Miss Dflano: 

At the last moisting of the Committee on Nursing of the 
General Medicnl Htianl, of the Council of National Defense, 
a motion was pnKsed expressing our approvnl of the method 
of enrolhnent adopted by tlio Nursing Service of the Red 
Cross. 

I am very glad to transmit this motion to you and to add 
that thoiie of us who have watched the careful, thorough work 
of the past seven years which has gone to building up this 
important branch of the Red Cross, feel that a very great 
national service has been rendered. For not only has there 
been created a large body composed of trained, skilled and 
competent nurses t^ form the Nursing Service of the Red 
Cross, but tho establishment and maintenance of proper re- 
quirements for enrollment in this service have acted as a 
valualde stimulus to hospitals and training schools in urging 
them to improve their standards of training in order that 
their graduates might be eligible for such enrollment. 

In no other country in the world has the Red Cross such a 
record. On the contrary, it« effort throughout history has 
generally tended to weaken instead of to strengthen g<»od 
nursing standards^ and consequently and inevitably to impair 



^ 



i 




MOBILIZATION 



260 



I 



the efficiency of ite nursing service. It is our hope that you 
may be able to maintain tlio high 8tan4lard8 you have net for 
your life-saving work and that our great dependence for 
Dursing the sick and woumled men of our army may con- 
tioue to t>e placed upon skilled and capable workers. 
Faithfully youre, 
(signed) M. Adei*aide NrrriNo. Chairman, 

Committee on Nursing, the General 
Medical Board of the Couucil of 
National Defense. 

The immpdiate steps taken during the early pnrt of the sum- 
mer of 1017 by the Nutional CimituitttJC on Red Cross Nursing 
Service and its smaller cxcvutivi' group were dirt^ctcd toward 
the one main purpi>8p of iucntasing cnrolluieiit. To this end, 
all State Boards of Examiners were urged to announce more 
friHjuent examinations of graduate nurses desiring to register 
under state acts and to pass upon examination papers with 
the utmost dispatch so that nurses might enroll without delay. 
State Boards of Registration were asked to furnish the Red 
Cross with three classified training school lists, giving in one 
the names of all t}u)8e schooln which met the Red C'rnss require- 
ments, in another those on the border line and in tbe third those 
which were Ijelow. Local Coniniittces were written to and askrd 
to select nurses for service. Letters were sent to a selected 
group of women in dose touch with National Headquarters, 
urging them to take the nurse's training. A special committee 
of nursea in New York City^ all of whom were Red Cross 
members, and who afterwards became Icadijig figures in the 
Committee on Nursiug under the Council of National Defense, 
undertfHik to arousti educators and educatiuiial iustitutiona espe- 
cially and 80 to direct large numbers of applicants to training 
schools. 

With the end of the war the executive committee of the Na- 
tional Committee ou Red Cross Nursing Service summed up 
itfl meetings and recommendations us follows: 

Eight meetings of the executive committee of the National 
Committee on Red Cross Nursing Service have been held 
since its authorization. 

Action was taken on the following questions, in earh in- 
stance a quorum of the Nationnl <'i>ninnttw being present: 

I. Plan for puhlirity campaign — beginning with a syndi- 
cated article in magazines and newspapers. 




260 HISTORY OF AMERICAN RED CROSS NURSING 

2. Definite request to be made to the American Red Cross 
for au expert publicity man to assist tbe committee. ^m 

3. Resolution adopted and sent to the president of Vassar ■ 
College on establishing a preparatory course in nursing for 
college women (Vasnar Flan). ^J 

4. Ijctter submitted to the Surgeon GeneraFs office re-^^5 
questing that j^ome actit)n be taken to combat the rumors of 
nurses returning from Europe pregnant. 

6. Nurses not eligible for active military service and in 
charge of training schools for nurses to be enrolled as re-^^H 
cruitiug agents. ^^ 

6. "Special enrollment" for nursey through Divisions for 
Home Defense (physic-ally unfit for military service, over 
age, married and tlnsse holding important positions who 
should not be disturbed). 

7. Uniform of Dietitians. 

8. Reeonmiendation that receipts from the Metropolitan 
Life Insurance (-ompany for Town and Country Nursing be 
paid to the organizations supporting nurse, rather than to 
Headquarters. 

9. recommendation that Miss Clement, Director Town and 
Countr}* Nursing Service, draft all recommendations with her 
personal opinion regarding the further development of rural 
nursing. 

10. Service Flag. 

11. Cooperation with the Woman*8 Committee of the N"i 
tional Council of Defense in their campaign on Infant W< 
fare, as far as possible. 

12. Plan to secure rank for nurses. 

13. Circulnrisip Boards of Registration for Nurses and State 
Afi60<;iation8; circularize the superintendents of training 
schools for nurses ; circularize the Sisterhoods ; circularize 
the non-registered [inrscs; circularize tlie subscription list of 
the American Journal of Nursing, 

14. Prepare plans for publicity campaign and launch as 
soon as the committee on publicity (consisting of chairnmn 
of National Committee on 1\kh\ Cross Nursing Service and 
representjilives from the thrci' national orgnnizations) de- 
cide<l it was practi<'al and if possible immeaiately following 
the drive for Liberty Bonds. 

The moat important details co\*cred by some of the above 
resolutions will be dealt with in later pages. 

Of all the subjects named in the list above as taken up by 




MOBILIZATION 



261 



I 



the National OonunitteL' on Ri!d Cross Nursing Service, none 
was more perplexing than that one alluded to in paragraph 
four. Elusive whispers of scandal touching Ited Cross nurses 

Jand gruesome tales of mutihition suffered by them, reached the 
Nursing Service early in 1017, persisting throughout the war 
and even after the Armistice. The Red Cr<»9!* files have an 
extraordinary series of letters written to Alias Delano or sent 
to her by the recipients, with her answers. The letters, usually 
written by friendly loyal persons, related with indignation yet 
often, too, with misgivings the alarming rumf^rs. Fifty such 
letters, analyzed for the purpost»s of this lustory, may 1)6 thus 
summarized. The rumors fell uiidiT three heads. First, — 
that Red Cross nurses abroad had beoonic victims of forcible 
outrage by enemy soldiers, or even by Allied uflioials, and that 
numbers of them (the immbers, always nii^iitinned, varied from 
^ij to several hundred) had become pregnant and were being 
brought home to be cared for in American hospitals. Names 
of hoepitols, especially two well-known ones in New York 
City, were sometimes specified. Second, — that Red Cross 
nurses, as a result of forcible ontnigc or personal immorality, or 
both, had become infected with venereal disease and were quar- 
antined at a French port, usnally named. In this legend also 
the numbers ran high ; the writer personally heard that nine 
hundred such victims, all nurses, were behind stockades at a 
locality in France. Third, — that Red Cross nurses had come 
back to their homes with eyes gouged out, tongues slit, or hands 
azkd toes cut off. 

It soon became clear that these rumors constituted a definite 
propaganda, arising from an unknown source. This might 
have had one of two purposes; one, to add fuel to the flames of 
hatred against an enemy; two, to retard the enrollment of 
noTBCB in the Red Cross and thus endeavor to cut off at its 
Bource the supply of nurses to serve in niilitarv hospitals. 

■ The Committee on Nursing Service concluded that while 

■ both purposes were served, the latter was the one directly aimed 
at and indeed, while enrollment was not prevented, its course 
was often made infinitely difficult by the popular reaction to 

»the rumors. 
The Nursing Service, desirous of avoiding publicity in the 
daily press as tending to assist the propagandists, took up each 
report separately as it reached noadquartcrs. Such word usu- 
ally came in from some nurse or Red Cross member, indignant. 



262 HISTORY OF AMERICAN RED CROSS XURSIXG 



shocked and incredulous, yet having at hand no way of making 
authoritative deniaL They were then given a categorical denial 
by the Nursing Service and were requested to obtain and for- 
ward to ileadqunrters the names of persons from whom the 
rumor was heard, with dates and names of places involved. 
Every such elue was painstakingly followed up and invariably 
ended in nothing. 

It was, however, learned that the mode of starting the rumors 
on their way was this: On a railway train of some small rail- 
road, in a remote or provincial region, a well-appearing woman 
traveler, getting into conversation with other travelers, would 
modestly mention herself as a Red Cross worker from abroad 
and would then witb deep feeling relate moat confidentially the 
horrid tales, presently alighting at some small town, there to 
disappear without trace. Or again, travelers in a far distant 
locality, again on the railway, would be attracted by the sight 
of two apparent invalids, so heavily bandaged as to be practi- 
cally invisible and would learn from a kindly woman or man 
in charge that they were Red Cross nurses whose eyes had been 
put out, tongues slit, or bunds chopped off. In no instance did 
any one see beneath the bandagt^s. 

As these tales were whispered from one to another they 
sometimes got into local papc-rs and were often given credence 
by well-meaning but ill-balanced persons. Statements based 
upon them were Oi^casionally recklessly made at public meet- 
ings, sometimes even at hH?al Red Cross meetings. An embar- 
rassing detail in counteracting tbera was that members of an- 
other national society of the highest standing more than once 
disseminated these absurdities, as proving the need of their 
own ministrations and of tlie enlargement of their own facilities 
in the war zones. 

The rumors were dealt with almost entirely by the Red 
Cross. In several instances the Department of Justice was 
called on for assistunee. One quite prominent woman physi- 
cian was called before a federal jury and reprimanded and in 
another case a man was fined $1000 and costs. Similar nimora 
were set on foot regarding Canadian nurses and Government 
circles in (^inada had the sjime difficulty in denouncing them. 
The tales were ususlly repeated with no malicious intent and 
were well known in nursing circles, but there, naturally, were 
not be!ievc»d. The following letter written by Miss Delano ia a 
type of the many that she wrote in this cuuuectiou: 



MOBILIZATION 268 

December 4, 1917. 
Hy dear Mr. 

Your letter addressed to has been referred to me 

for reply. 

Similar mmors have come to this office from time to time, 
and I can only assure you as emphatically as possible that 
there is absolutely no truth in the statement. We have alto- 
gether about four thousand nurses, about three thousand of 
fiiese in service in France. They are definitely assigned to 
base hospital units under military authority, or under the 
direct supervision of the Red Cross. Of all our nurses in 
France only two or three have returned, and it would be 
impossible for any large number to be brought back in the 
condition mentioned in your letter without the Red Cross 
being fully informed of the matter. 

Would it not be possible to take up quite definitely with 

T F , who has circulated the report, this matter, 

compelling him to give the source of his information and as 
a lawyer interested in Red Cross activities take such steps as 
may be necessary to prevent the repetition of this untruth 
in your community ? I can well understand that you would 
hesitate to do this without definite information from Head- 
quarters. 

I may assure you that there is no foundation for the rumor, 
A similar rumor is being circulated concerning Canadian 
nurses and I wrote to the Department of Militia and De- 
fense, Ottawa, Canada, for a definite 8tatcniv:nt, which was 
promptly received, denying absolutely all foundation for the 
rumors. It seems evident that it is a definite propaj^anda 
which should be met as promptly aH possible. We have tried 
to avoid any newspaper publicity, as it would only spread 
the rumor. 

I shall appreciate greatly any further information you 
may secure, and hope for your cooperation in branding such 
rumors as malicious falsehoodn. Appreciating greatly your 
having written to the Red Cross direct. 
Believe me. 

Sincerely yours, 

(signed) Jane A. Delano, Chairman 
National Committee on Red Cross Nursing Service, 

As the magnitude of the war tasks lx?camo plain, extensive 
systems of coordinated effort were woven into the sfK-ial fabric 
and the energies of nurses, bent to the snpprjrt of the Hed Cross 
Xursing Department, or to as.s^>ciated war-working groups, gave 
results that are distinctive in international lied Cross nursing 



264 HISTORY OF AMERICAN RED CROSS NURSING 



history, uot only for the bold and original methods adopted,] 
but also for the proof that, even in war emergency, an exteu-1 
sive increase in nursing personnel is possible, without seriously] 
lowering the hard-won standards of professional competency. 

Early in June, 11)17, an Emergency Committee on Nursing 
was organized by Miss Nutting and Miss Wald in New York 
City to include a number of prominent nurses, all of whom 
were members of the Red Cross National Committee and one oi 
whom was Miss Delano, as also several prominent physiciam 
witli iliss -lulia I^itlirop, Chief of the Federal Children' 
Bureau, The purposes of the Committee were: "to devise th 
wisest methods of meeting the present problems connected with 
the care of the sick and injured in hospitals and homes; the 
educational problems uf nursing; and extraordinary emergen- 
cies as they may arise." 

The founders of this Emergency Conunittee had been fearful, 
that under the great excitement of war, the usual objects of 
their care might l)e neglectt^i and they planned to guard those 
objects; i.e., the daily nursing of the sick in the homes and. 
hospitals and the teaching and preparing of nurses for their 
fields, while the Red Cross, olEcially charged by the govern- 
ment to be directly resiK)n8ib]e for war nursing would naturally 
\n} absorbed in that immense obligation. With the formation 
of the Council of National Defense (composed of the Secre- 
taries of War, Navy, Interior, Agriculture, Commerce and 
Labor) an Advisory Commission of seven specialists was nomi- 
nattMl and appointed by President Wil3f)n. Dr. Franklin Mar- 
tin, as one of the seven, organized the General ]Medical Board 
and this lioard took over the Emergency Committee and made 
it the National Committee on Nursing of the Council of Na- 
tional Defense with Miss Nutting as. its chairman, to function 
under the dii'eotion of the chairman of the (teneral Medicrtl 
Board. I^r. Martin himself being chairman of the Committee 
on Medicine and Sanitation of the Board, came into close 
oirrespondcTice and professional contact with the nurses on all 
the committees. There was also under the Council of National 
Defense a atilx'oramittee on Public Health Nursing and a com- 
mittee on Home Nursing. Jlisa Delano had a place on each 
and her special part in their conferences was to prevent as far 
as possible overlapping and duplication of effort, as from her 
post at Red Cross Iloudquarters, she had a knowledge of the 
entire field which none of the others could possess. 



MOBILIZATION 



265 



I 



I 



Ab the national pace speeded up, frictional reduplication of 
activities was not always preventable and it may be reasonably 
concluded that the single task of nursing during the war would 
have evolved more smoothly and expeditiously had the Nursing 
Committee of the Council of National Defense organized itself 
for its special interesta under the Red Cross (as a subcommittee 
of the National Committee) and this the more as they were all 
Red Cross Nurses and the maj(»rity of them memlKira of the 
National Committee on Red Cross Nursing Servicre. 

Miss Nutting's committee, as it was informally called, had 
from the beginning a special concern for the underlying edu- 
cational factor in nursing and to its leaders it could not have 
seemed otherwise than that they were specially responsible for 
that trust, for clearly the Red Cross alone, as then organized, 
could not have cultivated the educational field in addition to 
its vast administrative domain, but its readiness to cooperate 
and contribute show that the second cx^mmitteo would have had 
equally wide scope had it been a special Red Cross committee. 
Mi:*s Nutting's committee stood close to the educational world 
and its activities bore the impress of her original and boldly 
resourceful mind. Her suggestions and plans gave great im- 
petus to those intensive yet educationally sound courses opened 
for nurses in women's colleges, in connection with hospital 
training, of which Vassar gave the most highly perfected ex- 
ample, to be presently dcserilw^d and known as the Vassar 
Plan. In the recruiting of pupils for the training schools, in 
the movement to induce schools for nurses generally as a war 
duty to admit college women for training on a two-year instead 
of three-year basis, and in tlu' inception of the Army School 
Miss Nutting's <^mmittee did original and distinctive work. 
Of permanent value to nursing literature are the committee's 
nine pamphlets, most of which were prepared by Isabel Mait- 
land Stewart, a professor in the IVpartment of Nursing and 
Health at Teachers College. Their studies of war nursing 
problems should make them useful to the Red Cross societies 
and nursing associations of other coniitrica as well as to our own. 

The committee on Home Nursing, Miss Wald its chairman, 
was closely tied to the Department nf Labor and concerned 
itself primarily with all aspects of industrial nursing, so called, 
especially in those industries which were engaged in war work, 
axid with strengthening public health nursing in industries and 
b the homes. 



266 HISTORY OF AMERICAN RED CROSS Nl'RSING 



ti 



The purposes of the Rubcommittee on Public Health Niirft-^| 
ing and some parts of its plans are told in the following e» 
cerpts: 

This committpe was created hy Surgeon Genornl Blue fo; 
the purpose of relnting the work of the public health nurstf 
to the many problems of hygiene and sanitation brought into' 
prominence by the war. These problems are suggested by the 
names of the other sub-committees of the Committee oii 
Hygiene and Sanitation, for example, the Committee orf 
Alcoholism, the Committee on Venereal Disease and the Com- 
mittee on Drug Addiction. 

The public health nur^e must be the instrument which will 
make preventive medicine fffective. It is wise, therefore, to 
create a body, the function of which shall be to study the 
chanj:;iiig conditions produced by the wjir and to be ready to 
recommend to any given community a plan for establishing" 
a public health nursing agency whenever these changing con-^ 
ditions demand it. First: The purpose of the committee is^| 
To collect and edit material relating to the disastrous effeeta 
of the last three years of war on the community health of 
the Kurop>eaD nations at war. Second : To procure informa- 
tion of Uie present status of eommunitv' health work in thia 
country and of the extent to which such work is endangered 
by a state of war, and, further, to procure information as to 
tlie nee<l of the greater extension of it hy a «tate of war. 

Community health work in areas about the cantonmenW 
muiit be undertaken by public health nurses. Therefore, the 
Nursing Bureau of the Hed Cross is asking the help of thii 
committee in enrolling all public health nurses for publi 
health nursing service either here or in Europe, and is furthe: 
turning to the secretary of this comniilteo to lut in an ad 
visory capacity for the selection of public health nurses for 
these areas." 



i 



This subcommittee gathered important data bearing on pubrl 
lie health activities; made a special censns of public healtlfj 
resources, agencies and nurses at home: assisted the Red Cro* 
in securing nurses for the sanitary zones surrounding cantons 
inenta; initiated at Teachers College, with the help of Miafti 
Nutting and through scholarships donated bv tlie Red Croi 
the educational preparation for ten nurses necessary in thai 
C4impaigu against vencn'al diseases (Conducted hy Surgeon Gen*^] 
eral Blue; gave impetus to the loug-discuased plan of intrtw 

* Rvport of Subcommittee un Public Henlth Nursing. November, 1017. 



MOBILIZATION 



267 



ducin^ preliniinarv public health instruction into the senior 
Tear of training schools for nurses and was especially promi- 
nent in ur^ng that public health nursing should be accepted 
&i the equivalent of active militarj' duty. 

Miss Delano wrote of nursing groups cooperating in mobili- 
ution : 

The Bed Cross is working in close cooperation with the 
American Xurses' Association^ an affiliated body with which 
it has for many years enjoyed intimate and harmonious rela- 
tions. Prartically all of the eiirollod Red Cross nurses are 
included in the momheryhip of this association. 

Another or^nization with which the Red Cross is co- 
operating is the National Committee on Nursing, recently 
apI>ointeil by the (*ouncil of National Defense with M. Ade- 
laide Nutting as chairman and Ella P. Crandall as secretary. 

The Red Cross is coiiperating with this committee in a 
movement to enlist young college women in nursing as a 
patriotic service. As the Red Cross sees it, the big problem is 
not only providing for the present nursing needs but safe- 
guarding against tlie possible needs two. three and five years 
from now. Therefore, it is urging the young women of 
America to prepare themselves for the most eflicient work as 
nurses by submitting themselves to the training courses of 
high class schools of nursing. Several of our leading schools 
have agreed to admit graduates of approved coUeges, who ar 
otherwise acceptable as candidates for nursing, to specia 
courses whidi will grant them credit for one ncftdemic year. 

The Red Cross will rely upon the thousands of Red Cross 
Cliapters^ brunches and auxiliaries, the WomcnV (\iinmittce 
of the Council of National Defense, and similar organizations 
of women to supply lists of volunteer workers when needed. 
These organizations are already compiling lists of volunteers 
in the various communities. 



'I 

il^^ 



To give a complete list of all the groups and associations 
that aided the Ked Cross Nursing Service would mean, in 
effect, listing almost all those engaged in war service, but three 
n&mt^ that muat be especially mentioned, aside from the na- 
tional nursing groups, as cooperating agencies entitled to special 
appreciation were: the American Council of Education; the 
Association of Collegiate Alumnaa; the United States Food 
Administration. 

Of the special courses designed to facilitate mobilization by 
ikorteuiug the period of hospital training and giving instruc- 



268 HISTORY OF AMERICAN RED CROSS NURSING 




tion Tinder college auspices, that at Vassar was the first and 
set the moat excellent example to others. The generous inten- 
tion of the college to offer its ample facilities during the sum- 
mer of 15)18, '*as a training school for young women for patri- 
otic service in whatever lines of work offer the greatest oppDr- 
tunitiea or present the greatest needs" hud h<'en divliired hy 
resolution at a meeting of the Pn)visknml Alumna^ Council on 
June 1*, 11*17. The committee who reeomrm^nth'd the inirsing 
course as iinally established were: Mrs. John Wood Blodgett^ 
chairman, Frank R. Chambers and Frank L. Babbitt. To this 
decision Miss Nutting's counsel had largely contributed, and 
toward the success of the course Mrs. Blodgett's brilliant ser- 
vices were inestimable. 

The course offered pupils twelve weeks instruction in 
anatomy and physiology, bacteriology, chemistry, hygiene and 
sanitation, elementary mat«Tia mediea, nutrition and dietetics, 
the psychology and sociology of nursing, nursing ethics and 
history, elementary imrsing procedures with models, and spe- 
cial lectures. This was a>mbined with a disciplinary regime 
and physical training. It was followed by two years of work in 
selected schools of nursing connected with hospitals. Those ^H 
consenting to join in the plan were called Cooperating Schools ^H 
and Hospitals. 

The League of Nursing Education gave three of its members, 
Isabel M. Stewart, A. M., professor of Nursing, Teachers 
College, (>olumbia University; Elizabeth Burgess, B. S., State 
Inspector of Training Schools, New York, Education Depart- 
ment, and Anne Strong, A. B. (Bryn Mawr), assistant pro- 
fessor of Public Health Nursing, Simmons College, Boston, as 
an advisory committee to arrange the curriculum in coopera- 
tion with the Vassar faculty memb(»r3. The expenses were also 
cooperatively met. The Associated Alumna? of Vassar bore 
the cost of the publicity and recruiting campaigns; the pupils 
paid moderate fees and the Red Cross War Council on Januaiy 
9, 1018, appropriated $7r>,CK)0 for the gt'uerul expenses. 

By the time the Armistice was signed nearly tifty colleges, 
as reported by Miss Nutting's committee, had completed their 
plans for opening similar courses to student nurses, if such 
should have been made necessary by the continuance of the 
war. Courses in eight colleges had been formally approved by 
the Surgeon General. 

An encampment for lay women was that of the Women's 



MOBILIZATION 



269 



Section of the Navy T^agiir next to be mentioned. Its official 
leaflet gave the following statement of its plan: 

The National Service Sohool, Ino,, was organized by the 
Women's Section of the Navy League in 1910, to train 
American women for the duties wiiich come to them in war 
timefi and in other national disasters. Tlie first National 
Servicre School was held at Chevy Chase, MarylHiid, in May, 
1910. Nearly one thousand students were trained there and 
the American Red Cross, the Army, the Navy and tlie Marine 
Corps cooperated in the instruction and running of the 
school. Thus the instruction and methods used were standard 
and otficial and had been worke<l out by experts. Since May, 
the following National Service Schools have been held: Sec- 
ond National Service School, The Presidio, San Francisco, 
California; Third National Service School, Lake Geneva, 
Wisconsin; Fourth Xatiouat Service School, Narragansett 
Pier, Rhode Island. 

There were three courses, any one of which might be selected 
at the preference of the student. They included First Aid; 
making snrgica! dressings; signal work; wigwagging and 
semaphore; knitting and plain sewing; bicycling; plain teleg- 
raphy and wireless; household hygiene and home care of the 
sick. 

The question of the instruction of Red Cross nurses* aide 
is rooted in the early history of the Nursing Service, After 
the lied Cross became affiliated with the American Nui*ses' 
Aasociation (1901)), there had Ix^en no mention until the year 
lftl2 of the volunteer aide so familiar in Europe. Then, fol- 
lowing the Ninth International lied Cross Conference in Wash- 
ington, there was a movement to form Women's Detachmenta 
on the European plan. This step was questioned hv Miss De- 
lano, as shown in the following letter written by her at that time, 
(Letter from Miss Delano to Miss Boardmau, September 27, 
1912): 

... I do feel that the outline of instruction ^ves a wrong 
impression of the ol)je<'t of the i-oursc and can only repeat 
what I said this afternoon in repird to the possible dangers. 
This paper will reach a great nuniher of people and I con- 
fesB that the possible results worry me. 1 did not speak this 
morning of the effect this new undertaking may have upon 
the nursing service, but with no provision for cooperation, I 
see poaaibiiities of future misunderstandings and friction. If 



m 




270 HISTORY OF AMERICAN RED CROSS NURSING 

we have Red Cross nursing committees located in various 
cities and towns throughout the country, working as we hope 
in cooperfttton with the Hed Cross Chapters, the institutional 
members and the committees appointed by the American Medi- 
cal Association, would not this detachment of women working 
apparently independently, be a source of confusion and mis- 
understanding? How could one be sure that work would 
not be duplicated with inevitable friction and misunderstand- 
ing? I know so little of the details of this present organiza- 
tion that my opinion may be valueless, hut I see nothing to 
indicate oooperatiou or definite superviiiiion. In organizing 
the Ked Cross enrullnuMit of nurses and in planning for the 
rural nursing, it has always seemed most important to me to 
have the advice and support of physicians. In the same way, 
I can scarcely imagine the organization of courses on home 
nursing without the cooperation and interest of nurses. 

We can scarcely compare the couditions in this country 
with those in France. The training given their nurses ia 
most inadequate. 

In the written schedule of work I am in doubt whether 
the term "nurse" refers to graduates or to members of the 
women^s detachments. If the latter* I am wondt^ring how it 
will be possible to teach aseptic surgical technique in the time 
allowed for First Aid and home luirsing. I do not mean to 
make ditficulties. I am sure you will believe this, but think- 
ing only of the ultimate good, my mind is ftllcd with doubt.s 
and misgivings. I have spent three years in building up the 
Red Cross enrollment, and have always beJieved that the suc- 
cess of the Hed Cross and its activities depend*^ primarily 
upon the coordination and the cooperation of all its depart- 
ments. 

Mias Delano brought this subject before the American 
Nurses' Convention in 1912 and on November 14, of that year, 
the members of the National Committee on Nursing disap- 
proved the plan of a separate Wonicn-s Detachment, but gave 
unqualified approval to the organization of classes of women for 
instruction in First Aid, home care of the aic^ and allied sub- 
jects designed to aid women in the care of their own families, 
and pledged the cnopKration of nurses for such teaching.* 

It was Bubseqiunitly agrc<»d by the Red Cross that indepen- 
dent Women's Detachments should not bo organized ; that 
classes for women (except those in First Aid) should be 
directed by the Nursing Service and that a volunteer service 

^Amtrioin Journal of Surfing, December, 1912, 



MOBILIZATION 



271 



i 



of women, if Buch should ever be required in war, should be 
Qnder the direction of the Red Cross Nursing Service. 

The classes for women in Home Care of the Sick and Home 
Hygiene, which later developed widely, thus partly arose from 
the relinquished plan of Women's Detachmeuts. With the 
tlirentcned warfare of the Mexican border, li)l(), and the estab- 
lishment of base hospitals there, the National Committee on 
Red Cross Nursing Service, at a special meeting during the 
Convention of the American Nurses' Association at New 
Orleans, 11*10, had agreed that the nurses' aides, if needed, 
should be a responsibility of the nursing profession, which they 
would not evade, provided that their teaching and duties were 
justly defined in relation to the actual care of the sick, 

"Volunteer nurses' aides" were, in fact, called for in 1916 
and their status was thus denned by Colonel Jef erson Randolph 
Keua, Director of Military Relief : 

Volunteer Nurses^ Aide^. Provision has been made for the 
assignment to our base hospital units of a limiled number of 
women who are not nurses by profession. They will serve 
without pay but may be furnished with transportation, lodg- 
ing and Hubsistencc. wlinn the unit to which tlipy are attached 
is called into active service. Nurses' aides will be prepared 
for duty under the supervision of the nurt-ing service of the 
Red Cross and will be required to take at least the course 
of instruction in Elementary Hygiene and Home Care of the 
Sick and pass a i^atisfiu-tory examination in the same. It is 
alfio ilesirable that they take such other courses of instruction 
as may be provided by the Red Cross. The chief nurse of the 
base hospital unit will be respoubihle for the selection of 
all nurses' aides attached to her unit and will, if necessary, 
arrange for their instruction. When railed into service they 
will serve under the direction of the chief nurse of the unit.^ 

To this explanation Miss Delano added : 

Practical experience as nurses or partial training as such 
cannot be accepted in lieu of our course in Elementary 
Hygiene and Home Care of the Sick, as one of the chief ad- 
vantages of this instruction given by a Red Cross nurse is to 
enable the Red Cross by observation to judge of the qualifica- 
tion of those taking the course and their probable fitness for 
service. 

:'Ulu DeUno in Amcricon Journal of yursing, September, 1916. 



272 HISTORY OF AMERICAN RED CROSS NURSING 

While most lay women voluBteering for service imagine 
themselves giving aid on the hattlefiolds, as a matter of fact 
tht7 will not be upsi>,'ncd tn duty witliin the zone of military 
operations. Their diicf ypliore of UHufidnoss will be in supply 
rooiu«, linen rooms, diet kitchens, laundries and the wards 
of base hospitals located considerably in the rear of military 
operations. Assignments to duty both of nurses and nurses' 
aides will, in all cases, be made through the Ked Cross Head- 
quarters, Washington, D. C. . , * 

As the orgjmization of Ked Cross base hospitals progressed, 
the National Committee on J{cd Cross Xursing Service, at a 
meeting held in New Orleans in April, 10 H>, recommended that 
practical instruction for nurses' aides be limited to seventy-two 
hours a month, for three hours daily in the morning in consecu- 
tive days, Sundays and holidays excepted. This training was 
optional with the parent hospital authorities and these volun- 
teer aides formed no part of the civilian hospital stalf except 
when as a base hospital unit they were called into active 
service. The following guide to practical instruction which 
was prepared by Miss Noyes as one of her first duties in the 
Nursing Service in September, 1917, was recommended by the 
National Committee: 

Service in Wards: Sweeping and dusting; cleaning lavatory | 
utensils; rJeaning. airing and making beds; care of soiled ' 
linen; care of olean liiifu, hlanlvftiJ, rubber gmids; serv- 
ing trays, feeding helpless patients; serving water and 
nourishments; washing nourishment dishes; preparing 
patients for the night ; c.iare of heads; bed baths. 

Service in Surgical Supply Room: Preparation of surgical 
dressings, mending rubber gloves; preparation of goods 
for sterilization. j 

Servi(;e in Central Linen Room: Folding, ejcamining and ' 
stacking linen; sewing on buttons, tapes; assisting with 
exchanges. 

Service in Connection with Operating-Boom: Assorting and 

folding linen; dusting and cleaning; cleaning rubber ^^ 
gloves and instruments ; admission to oi)eration6 not '^B 
approved. ^^ 

Service in Diet Kitchen, Sewing Hooms and Laundry may be I 
arranged for such nurses' aides as have indicated special i 
preference for work in these departments. 

Additional Suggestions. Careful rwords as to hours and 
duties performed, interest displayed and attitude toward 




MOBILIZATION 



^73 



the service should be kept. As service with a base hos- 
pital in time of war is a serious one, it is important that 
the aides elected to accompany euch should be women 
of dignity and purpose. In order to maintain interest, 
the practical work may be repeated eadi year. Confer- 
ences with appropriate talks or lectures might be held 
during the interval between practice periods. Permanent 
vacancies which may occur should l>e filled from the re- 
serve list and under these circumstances the muster roll 
may be signed by card. 

When the United States catered the World War the National 
Committee on Red Cross IS^ursing Service on April 28, 1917: 
"recomraende<l that courses i]i practical work for lay women 
shall l)e giv<Mi in }io8f>itals selected by the N^ursing Service and 
that sucii courscH ahull he on the same basis as planned in 
eonnectiou with base hospitals" and the following regulations 
were agreed upon: 

The term '*Eed Cross nurses' aide" is applied to those 
women who have voluntarily pledgeil themselves to service 
after meeting the following definite requirements of the Bed 
Cross : 

First : The satisfactory completion of the course in Elemen- 
tary Ilvgiene and Ilome Care of the Sick, authorized by the 
Red Cross (A. H. C. 704). 

Second: Selection for service and eight hours daily of 
practical hospital experience for one month (this was later 
extended) in a hospital authorized by the Ked Cross. 

Selection 
Women who have had the course in Elementary Hygiene 
and Home Care of the Sick may be recommended for service 
as nurses' aides bj' the chief nurne of a base hospital unit, 
by the superintendent of the training school of the hospital 
around which a unit may have been organized, or by a Di- 
vision Director of Nursing. The Dual decision rests witli the 
Department of Nursing, American Red Cross, Washingtou, 
D. C. 

Qualifications for Service 

1. Age. Preferably between twenty-five and thirty-five. 

2. Freedom from home ties which might interfere with 
uninterrupted sennce. Unmurried women ov widows will b** 
given preference in assignment to duty. 

3. Satisfactory physical condition. 



274 HISTORY OF AMERICAN RED CROSS NURSING 



4. Adequate education and eredeutials. 

6. Special fitne^*? for such work. 

Exceptions to t!ieBi? general requirements may be made 
by the Dei)artment of Nursing in the case of candidates pos- 
eeesing special qualitioationB.^ 

In midsummer, 1918, the directions relative to nuraes* aides 
were sent out by the Department of Nursing as shown in the 
following letters: 

August 16, 1918. 
To All Division Directors of Nursing, 

From Director, Department of Nur8iug, 
Subject: Plating Xurses' Aides in Service. 

It has been decide<I by the War Council that the Red CroBB 
should, through its Divisional officers, undertake at once the 
training of a sulhcient nuniher of nurses' aides to meet the 
needs of the Ked Cross in Europe. This personnel is not 
intended in any way for service in niilitjiry hospitals, but to 
supplement the work now being carried on abroad in the care 
of refugees, infant welfare work, and similar activities con- 
ducted under the auspices of the Red Cross. 

The assignment of nurses* aides as provided for in this 
letter and the accompanying instructions must in no way 
interfere with the enrolling of Red Cross nurses for service 
under the Army and Navy, or under the Rod Cross. The 
War Department has asked us to increase our assignments of 
nurses to one thousand a week, and it is most urgent that 
the greatest effort be direi-tcd to meet this requirement. 

Each Division Director of Nursing sliould arrange imme* 
diately to recommend two hospitals located in the Divigion, 
to be selected as schools for instructing applicants for this 
work. In making this recommendation it is. of course, essen- 
tial that you consult and secure the approval of your Division 
manager. In order to avoid duplication of work, it is sug* 
gested that hospitals at which this experience is now given, 
be recommended. Only hospitals having training schools for 
nurses, which are on the accredited list with the State Boards 
of Registration and are in other respects acceptable, will be 
consiclered. If necessary, in order to roach a conclusion, 
final decision in the selection of the hospitals where this 
experience is to be gjven may be requested from National 
Headquarters. 

You should secure the service of a capable lay woman and 
any necessary additional assistants (also lay women), to assist 
'A, n. C. 707. InBtructlons fur Kuriea* Aitlea. 



MOBILIZATION 



275 



you in the supervision of the fielection of nurses' aides. It 
it ifl expected tJiat nurses' nides will he recruited largely from 
women who have taken tl»o Ked Cross course in Home Care 
of the Sick. A part of this assistant's duties, therefore, could 
include tlie development and stimulation of interest in this 
instruction course. 

In each of the two hospitals in your Division, there should 
be under instruction continuously twenty-live selected can- 
didates for nurses' aides. Only women should be selected 
for such experience ns give promise of being desirable for 
assignment, and otherwise meet the requirements prescribed. 

The accompanying instructions for the Division Bureau of 
Xursing provide the necessary protxnlure for recruiting and 
BUjHTvij^ing the instruction of candidates. 

After receiving the required hospital exi)enencc!, candidates 
will he enrolled for foreign service under tlie direction of the 
Division Bureau of Nursing and the Divi-:ion Bureau of 
Personnel will participate in the enroHniciit and assignment 
of nurses' aides in the manner prescribed by the accompanying 
instructions. 

Ten copies of the **'Memorandum Routine for Placing 
Nurses' Aides in Service'' are forwarded herewith and an 
initial supply of forms is being forwarded by express to the 
Division ohice. A complete copy of the Routine should be 
transmitted immeiliately to the Division Bureau of Personnel. 
Very truly yours, 

(signed) Jane A. Delano, 
Director, Department of Nursing. 
Approved: G. E. Scott, 

Acting General Manager. 

August 29, 1918. 
To Division Directors of Nursing. 

In my letter of August G, I stated that the War Council 
desired the selection of two hospitals in each Division to give 
practical experience to women who have had our course of 
instruction in Homo Care of the Sick and who are willing 
to accept service as needed. I realized that there might be 
difficulty in securing the admission of twenty-five pupils to 
each of two hospitals, and that it would probably be easier 
to use a larger number of hospitals, admitting fewer pupils. 
The decision in regard to two hospitals was, however, based 
on a request from the Surgeon General's office. Satisfactory 
arrangements have recently been made to allow for a change 
of plan, leaving the Dinsion Directors of Nursing, in con- 
sultation with the Division managers, free to make such 
selections of hospitals as they tliink most desirable, without 



276 HISTORY OF AMERICAN RED CROSS NURSING 

reference to the number of hospitals admitting pupiU. It is, 
however, understood that fifty women will be admitted each 
month for the required pericwj of hospital experience, making 
six hundred women to be prepared aa nuryes* aides each year 
in your Division. While the Hed Cross wishes to have this 
number available for ftervice through the Division ollices, 
it is impossible to guarantee assignment to duty. 

As they will be used for service abroad under the auspices 
of the American Red Cross, largely in France, they should 
have a conversational knowledge of French. It is, therefore, 
suggested that as far as poHSible a tentative selection of de- 
sirable women be made, even before they begin the course of 
instruction in Home Care of the Sick, and that they be 
urged to review and perfect their knowledge of French in 
order that they may he eligible for admission to the hospitals 
for practical experience, ujion Iho completion of the course 
in Home Care of the Sick. It is the desire of the Surgeon 
Generars office that wc shdiild admit fur practical experience 
in hospitals only such women as have a conversational knowl- 
edge of French. 

Yours very truly, 

(signed) Janb A. Delano, 
Director, Department of Nursing. 

The orders coming from tho War Department rogarding 
nurses' aides were variable. Aides were first called for, then 
countcrmaudedf then called for again. They were not, how- 
ever, in the end placed in military service through regular 
channels either at home or abroad. When tho Red Cross 
organized its extensive civilian relief flcrvieo in France, many 
aides served there as 8(H»retaries, interpreters, friendly visitors, 
etc., with groat acceptability. In all, up to July 1, 11)18, 
fifteen hundred nurses* aides enrolled and wert* assigned to 
active duty with tho Ked Cross. Their motives and spirit were 
excellent and as most of them spoke French and were gently 
reared women of social tact, their usefulness was often very 
great. 

As the cantonments of the United States were developed, a 
tide of popular emotional demand for volunteer "nurses," with 
a short course training, made itself felt and was difficult to 
stem. It was finally counteracted by tho plan for an Army 
School of Nursing to be described in another section. 

After protracted conference with tlie Surgeon Gener»rs nliice 
during the early summer of IDIS, the lied Cross Nursing 




MOBILIZATION 



277 



p 



Service made an attempt to organize a group of Reconstruction 
tides, women especially trained to give remedial exercises, 
eitlicr in physio- or occupational therapy, preacribod for the 
ore of patients in hospitals and other sanitary formations of 
the Army. Lists of nurses expert, in tliis specialized work 
were first collected by Miss Noye-a. A tentative plan of the 
Red Cross embra<!t»d the training of (college wonu-n in tlicsc 
branches. Josephine Saunders, of New York, was finally 
firen an app<">intnient in the Surgeon GeneraPa office to develop 
these gronps entirely within the War Department, but the Red 
Cross cooperated with the Army in mobilizing them, as is 
shown in the following description of these aides and their field 
of work: 

At a meeting of the War Council liH»l June 27. 1918, the 
following vote was passed and comniuni(.'atcd to Miss Delano: 

VOTED: That Appropriation No. for the purchase of 

equipment, including uniforniF for the outfitting 
of nurpt's be, and it is herewith amended to cover 
Recoiiistrui'tion aides (feamk') whu are being or- 
dered for eservice overseuH by tjie Surgeon General's 
ottiee, with the understnndiug that the Director of 
the Department of Nursing sliall confer with the 
Office of the Surgeon <.lenerftl of the Army as to the 
necessary uniform ami equipment. 

The War Department wrote to Miss Noycs : 

I am enclosing a circular sent to Reconstruction aides re- 
garding overseas and domestic equipment. Please let me 
know if this meets with your approval. 

1 am having mimeographwl a signed authorization without 
which no aide should be allowed to purchase equipment at 
cost from the Red Cross. 

(signed) Fiunk B. Granger. 

Through tlie Bureau of Nurses* Equipment in New York City, 
the Red Cross furnished complete equipment free of charge to 
Reconstmction aides assigiied overseas and supplied ward uni- 
forms at cost to aides employed in Army hospitals in this 
oount^^^ 

Leaders and assistants in recreational therapy, a highly 
'rl and specialized form of aid to invalided soldiers, had 
tn up the entrance to a field in ^vhich the Red Cross antici- 



278 HISTORY OF AMERICAN RED CROSS NURSING 



pated developing an extensive and useful service. These pinna 
were^ however, terminated with the Armistice and subsequent 
reconstruction of the Army hospitals. 

On April 23, 1017, tlie Ked Cross Committee on Nursing 
Service considered the whole aspect of the public health n\irsiug 
service in its relation to the war and at subseciucut meetings 
throughout 1017, the exemption of public health nurses from 
military service always called forth lively discussion. A sub- 
committee of the National Committee on Red Cross Nursing 
Service was accordingly appointed, which recommended a plan 
by which various groups of nurses then performing esseutial 
service were placed in a Special Service group. 

There were already certain groups of nurses w^ho were re- 
garded by the Red Cmss as exempt from active military duty, 
i.e., thow! at Red Cross Headquarters and in Division offices; 
Chapter supervisors; members of the Red Cross State and Local 
committees; members of the Red Cross Town and Country 
Nursing Service, and tliose holding important positions in 
hospital"}, training schools and public health organizations. 

The Special Service group as now defined gave public bciilth 
nurses, as well as those serving in hospitals, a recognition simi- 
lar to that accorded the nurses who enrolled fur war nursing. 
Such recognition had betMi asked for by the sulx^omnuttee on 
Public Health Nursing of the Council of National Defense 
(Aliss Beard's committ*^), on May 28 when it recommended to 
the Committee on Hygiene and Sanitation the advisability of 
seeking to obtain^ from the Council of National Defense, a 
"pronouncement" recognizing public health nursing as a war 
service. 

Brief extracts from the correspondence between Miss Delano 
and Wiss Beard give the clearest statements of this special enroll- 
ment. Miss Delano wrote, September 12, 1917: 

In view of the probable demand for public health nurses 
for work in the zones surrounding the military cantonments 
and possibly for public health work in France, the National 
Committee on Red Cross Xursing Service has provided for 
a special enrollment of public health nurses exempting them 
from other service, as has alreaily been done for the nurses 
enrolling as instructors. 

It would seem desirable, however, that a communication be 
sent from the subcommittee on Public Health Nursing or the 
General Medical Board of the Council of National Defense^ 



MOBILIZATION 



279 



bringing the importance of this service to the public health 
organizations* attention, and urging that they release a cer- 
tain pro})ortion of tlie nurses upon their staffs for enrollment 
with the Kcd Cross for thin service, I will in turn communi- 
cate with our Local Committees authorizing them to enroll 
nurses for this special service. 

In response to this letter Miss Beard sent to the various 
organizations for public health nursing a questionnaire, and an 
appeal, in which she said : 

So pressing is the immediate need for carefully selected 
nnr&es for public liealth duty that the Red Cross has asked 
this committee to mm] out an appeal to public health nurses 
to enroll in a special class exempted from all other service. 
This does not mean that a public health nurse may not en- 
roll for other duty. 

It will be a high mark of patriotism to serve in our own 
country. It may even become the supreme test of devotion 
to remain at one's regular post of duty. It is certain tliat 
the greatest discrimination must he exercised in the "selective 
draft"' in order tn avoid disrupting or seriously depleting the 
borne work while providing, from tht> already inadequate 
ranks of public licBlth nursing, our full proportionate quota 
for war duty wherever needed. 

This committee urgently requests yon to answer the en- 
closed questionnaire within three days of receipt and begs 
that your decision be made in the light of the nation's two 
great equal needs, i.e. : first, to guard the health uf our sol- 
diers and sailors and those of our allies; second, to protect 
our home defenses in the face of new dangers and increased 
demands.* 



Tlie regulations framed and issued by the Red Cross Nursing 
Service in regard to this special group were these: 

1. A nurse shall be eligible for enrollment in the Special 
Service group, providing she is an enroUcil Hod Cross nurse, 
eligible for active duty, yet holding a position in which in the 
opinion of the Ked Cross she is more valuable at present than 

'A. R. C. file, September 15. 1017; also Reports of Miss Ntitting'B 
onuttce. The qnoM ionnaire asked for : 1 . Name of or^nication. 
t. Kanm of staff mcmlKTn indifiprnHn1)lc loonlly. .1. Mt>nil>ors who could 
W Risrvd and whtm availabU'. 4. Cliaraotpr of service rt>nderG<l by each. 
A. Najnea of mcrabors then in active duty with the Red Croaa. 6. Name* 
•f tboae enrolled. 7. Thnso who had applied for enrollment. 8. Thoee 
iatfiuUng to apply for enrollment. 



280 HISTORY OF AMERICAN RED CROSS NURSING 

in war service. Nurses physically or otherwise disqualified j 
for active war service are not elitjiblp for this rnrollment. . , « 

4. A committee appointed by the Division Director, Bureau 
of Nursing Service, shall act upon applications and shall 
issue a chevron to each nurse whose application has heen 
approved. 

5. The nHUiPfi of nil nurses in the Special Service ^n^up 
will be forwarded to the American Ked Cross, Department of 
Nursing, at Washington, in order to prevent the assignment 
of these nurses to active war service. 

6. The Special Service eiirollment of a nurse relates to 
the position she holds at the time the chevron is issued. If 
a nurse changes her position, the person, organization or in- 
stitution which employs her shall immediately inform the 
Bureau of Nursing of the change of status and shall also re- 
turn the chevron. Nothing shall prevent the filing of another 
application should the nurse assume a new position in which 
Bhe may be essential to a community. 

Before making application for nurses in the Special 
Service group which entitles them to the chevron, consider- 
ation ahould be given to adjustments with the view of con- 
serving graduate nurses, i.e.: 

1» For utilization off student nurses wherever possible 
for positions as head nurses, social service and visiting nurses. 

2. Consideration of other assistants to graduate nurses, 
such as Home Defense Nurse, and attendants. 

The Special Service Chevron is to he issued by a com- 
mittee ap()oiuted by the Division director to such enrolled 
Bed Cross nurses as are fit for active service but are fulfilling 
important responsibilities in their present positions. 

After tlie committee lias granted a chevron no call for 
active military service will he sent a nurse, without consul 
tion with the Board by whom she is employed. By establis 
ing this "Chevron Service'* the Red Cross hopes to give 
nurses and organizations a freedom to develop the most im- 
portant teaching in training schools and in public health 
centers in order to conserve the health of our own i-ountry. 

If a nurse is not physically fit for active service or has 
personal responsibilities that make it impossible that she 
should go, she should apply for enrollment in the Home 
Defense, 

The form of the letter sent by the Department of Nursing to 
public health associations was: 

In view of the very great demands for nurses for military 
service and considering the many nurses disqualified for this 







MOBILIZATION 



281 



service, the committee respectfully recommend that every 
inetitDtion prepare now to meet the even greater need in the 
future and wherever popjsible, a nurse eligible for military 
service and now exempt from such service be aubatitutod by 
one who is not qualitied for such service. Our nursing re- 
sources being limited guch readjustments will be absolutely 
necessary. 

With the assurances that the Department of Nursing of 
the American Ked Crot;s has the interest of your iustitution 
at heart, 1 beg to remain, 

Very truly yours, 

(signed) Jake A. Delano, 
Director, Department of Nursing. 

The form of the letters sent to nurses entering the special 
service group was: 

Upon the recommendation 

you have been placed in the Special Service group of the 
American Red Cross Nursing Service and you are temporarily 
exempt from active military- service. You are hereby privi- 
lege<l to wear the enclosed chevron until such time as you are 
released for active service. 

With good wishes for the success of your present work; 
lam, 

Very sincerely yours, 

(signed) Jane A. Delano, 
Director, Nursing Service.** 

The form of the letter sent to nurses eligible for a special 
iBTvice chevron was: 

I note that you are holding an important position at present 
and since it is the wish of the Nursing Service of the Ameri- 
can Red Cross to disturb as little as possible the work of 
organizations such as yours, 1 am writing to learn if it is 
your wish to be considered for exemption from active mili- 
tary service at present ? 

We wish to aspociate all our good nurses definitely with 
the American Red Cross and are therefore placing nurses 
holding important positions in a Special Service group, issu- 
ing to them a chevron to wear denoting their exemption from 
active military service temporarily. 

I judge from your application that this is your desire 
»t since we can only cotie^ider such requests u[>ou the recom- 
^ndation of the head of tlie institution, I will ask you to 
'Special Serriee group. No. 6. 




282 HISTORY OF AMERICAN RED CROSS NURSING 

forward the eiiclnsed to jour president. When this blank 
is properly filkui out and returned to us, this recommendation 
will be acted upon b> the Committee on Exemption and you 
will be dulj' notified. 

The Ited Cross assumes that the president of every institu- 
tion and every nurse keeps in mind the fact that with many 
nurses disqualilied for military service, readjustments must 
be considered whereby every nurse eligible for active military 
service is substituted for l)y a nurse not so qualified. 

Awaiting your attention to this, I am, 
Sincerely yours, 

(signed) Jane A. Delano, 

Director, Nursing Service." 

An interesting example of the response met by these letters is 
the answer of Archdeacon Hudson Stuck, Fort Yukon, Alaska : 

September 18. 1918. 

... In accordance with your suggestion of August 18 

addresscil to our one remaining nurse, Miss N at St. 

Stephen's Hospital at this place, I make request tliat a *'Spe- 
cial Service chevron" be granted her. 

This hospital, located a mile above tlie Arctic Circle, is the 
only place where medical relief can be obtained in something 
like fifty thousand square miles. The nearest physician up 
the Yukon is at Dawson, three hundred fifty miles distant, 
Uie nearest one down the river is at the Army Post Fort 
Gibbon, another three hundred and fifty miles away. And 
in all the wide winterland, northward to the Arctic Ocean 
and southward to Fairbanks, there is no nurse. The explorer 
Stefansson, lying ill at Herschel Island, had himself hauled 
four hundred miles by dog-sled to reach our little institution. 

Miss i\. has been urged by her conscience and by some i 
of her friends to give herself up to war work. She would, 
however, be fortified in her resolve to remain here, I feel 
confident, did your organization distinguish her from mere 
slackers and absentees by the award of your "Special Service ^y 
chevron." m^ 

' Another special group mobilized by tho Red Cross was that ^* 
of the Home I)**fens<* nurses. The most important details of 
their enrollment plan are given: 

1. Purposes of Enrollment: 

The Red Cross Department of Nursing recognizes that in 
every community there are graduate nurses who for some 

"8|»eci«l Service group, No. 8. 



4 



MOBILIZATION 



283 



reason are not eligible for military duty but who are able to 
Tender valuable service in connection with emergencies, in- 
cluding local disaster, all forma of visiting and instructive 
nursing, institutional work, and as instructors in Elenicntary 
Ilypieue and Home Care of the Sick. A Bpecial onrfilhncnt 
for such nurses has been authorized with the desi^iatiou of 
Home Defense nurse. This enrollment is not iutctuled for 
those who meet the regular requirements for enrollment as 
Bed Cross nurses. 

. , . Division Bureaus of Nursing have the responsibility 
for the enrollment of these nurses. 

... An applicant must hold a diploma from an accredited 
achool of nursing ia the State from which slu' was graduated 
and be a member of the American Red Cross, and able to 
render some regular service. 

, , . Approved applicants for enrollment will receive a 
membership badge with a bar bearing the title "Home De- 
fense Xurgie,'' which will be issuetl by the Division Director 
of Nursing. 

. . . Nurses who have married or are beyond the age limit, 
physically disqualified or otherwise ineligible for military 
duty or other active service, will ho enrolled by the Hed Cross 
Divit^ion Department of Nursing for their territory under the 
special classification of Home Defense nurses. 

The Bed Cross instituted the Home Defense nurses' en- 
rollment because it believed and still maintains that the 
skill and experience of every woman who has had a nurse's 
training must be made available to the nation in some direct 
way. . . .'» 

Miaa Delano made special appeals for the Home Defense 

Service and her prevision was bl)mo out by the experiences of 

^Ihe influenza epidemic. To meet that emergency, married, 

and retired nurses came forth and, aa was often declared 

vr « Ked Cross lecturer, Dr. Thomas E, Green, helped greatly 

to save the day. 

The Army School of Nursing, though not originating with 
^H the Ked Cross, was a prominent feature of the mobilization 
^Bof Dorses for war and in its inception and growth was closely 
^^^■peu together with the processes of Red Cross enrollment and 
^BlKfi^mcnt for scn*ice. The construrtire idea which gave rise 
^■to the Army School was Miss Goodrich's, for she had been 
" Megatcd b^ the Surgeon General as chief inspecting nurse, 
vitb an sMUtant, also a nurse, to visit and inspect nursing in. 

■A. R. a Form 405. March, lfll8. 



284 HISTORY OF AMERICAN RED CROSS NURSING 



the cantonments. Their appointment had been made in re- 
sponse to a recommendation of the Committee on Nursing uo-^l 
der the Council of National IJefense and a similar proposition^^ 
offered by the Hospital Division of the Medical Department 
of the Council of National Defense. The report made by Miss 
Goodrich after the inspection included these words: **rt is 
therefore recommended that an Army sch^xil of Nursing be 
created and that we be permitted to present a detailed plan 
relating to the same." 

The rejK)rt and its recommendations wen^ eouflid(»red at a 
conference of Medical and Army wfiieers and nurses, the latter 
being Miss Delano, Miss Thompson, superint-endeni of the 
Army Nurse Corps, Miss Clayton, preHident of the National 
league of Nursing Education, Miss Burgesg and Miss Oood- 
ricJi. Miss Goodrich suhinitted full plans to the Surgeon Gen- 
eral, March 24, 1018, hut for reasons of space only a part of 
her outline can be here given: 

A plan whereby tlirough an Array School of Nursing the || 
most complete nursing care may bo provided for the pick and 
wounded soldiers at home and abroad, for the jieriod of the 
war and for as long thereafter as the Govornment may de- 
cree. . , . 

The plan to provide for an cany, constant and almost un- 
limited expangion of training fields and consequent increase 
in student and graduate nurses, in order that the arising 
demands of the service may be fully niet. 

Throu/jh the provision of the student body to have in the 
process of training large >n"oups becoming increasingly compe- 
tent thereby enabling the release of the most experienced 
nurses fr>r the foreign and other demanding fields without 
lowering the efficiency of the Imse hospitiils. 

To raise immediately the standard of the nursing care of 
the sick in the btise hospitals by tht> provision of an increased 
number of jwrsons to render such care. 

The plan as presented provides that the school, to be known 
as the Army School of Nursing sliall be located in the otVice 
of the Surgeon CJeneral. Through this otTice the enrollment 
of the students will take place and all maltj»rs relating 
to the general management of the school shall he dealt with. 
The farulty jiresided over Ity the dean of the school is t<y 
determine all questions relating to the course of instruction; 
the general administration of the school being entrusted to 
the dean. It is suggested that an Advisory Council be ap- 
pointed composed of members of the Medical Department; 



4 
I 

I 




MOBILIZATION 285 

the saperintendentfi of the Army and Navy Nurse Corps; 
the Director of the Department of Nursing, American Red 
Cross; the presidents of the American Nurses' Association, 
the National League of Nursing Education and the National 
Organization for Public Health Nursing; the dean of the 
school of nursing and other members of the nursing pro- 
fession conversant with the problems of nursing education, 
to make recommendations concerning the appointment of the 
faculty, the relations between the military and civil hospitals 
and other matters relating to the general policy of the 
school. 

In order that the school may come into immediate existence 
and that as large a group of students as possible may be ob- 
tained before the heat of the summer, the committee nmkes 
the following recommendations : ( 1 ) The immediate appoint- 
ment of a dean or acting dean of the school. (2) Details. 
(3) That the Ked Cross Department of Nursing be asked to 
issue to those who have successfully completed a course in 
Elementary Hygiene and Home Care of the Sick the applica- 
tion blanks and announcement in order that should these 
applicants desire to enter the Army School of Nursing and 
should they meet the requirements for admission they may 
be immediately enrolled. (4-5-6. Details). (7) That the 
dean be authorized to recommend for appointment a director, 
an assistant director, a full time instructor, and one or more 
part time instructors in addition to the regular nursing staff 
of each base hospital selected as a branch of the school of 
nursing. 

That the dean be authorized to confer with the (•ommand- 
ing officer and the chiefs of the medical and Kurgical staffs 
of such base hospitals as are selected concerning the ap- 
pointment of medical lecturers and instructors. . , . 

The Secretary of War approved the plan on May 24, 1918, 
and the Surgeon General apjwintcd the advisory committee: 

War Department 
Office of the Surgeon Genera! 
Washington. 

June 5, 1!)18. 
Office Order No. 53. 

The Advis4'>ry Council of the Army Scho<jI of Nurning ifi 
hereby appointed, the nicmhcrs of which Hhall be as follows: 
Colonel W. H. Smith, chairman; (,'olonfl (.'. L. Furbish; 
Colonel W. T. I/^n^rcope; Mi.s.- M. Adelaide Nutting; Miss 
Lillian D. Wald ; Mi.-.s Anna C. Maxwell; th*; superintendent 



286 HISTORY OF AMERICAN RED CROSS NURSING 

of \hv Army Nurse Corps; the superintendent of the Navy 
Nurse Ccirpa; the director of the Deimrtmeiit of Nursing, 
American Red Cross; the president of the Americnn Nurses' 
Association ; the president of the National League of Nursino^ 
Education; the president of the National Orpinization for 
Public Health Nursing; the dean of tlie Army School of 
Nursing. 

By direction of the Surgeon General, 

(signed) C. L. Frnnusn, 
Colonel, Medical Corps, N. A. 

At its second meeting, February, 1010, the advisory council 
recommended placing the school on a permanent foundation by 
Act of Congress and submitted this their resolution, together 
with an outline draft of a suitable act, to the Surgeon General 
for his approval. Miss Delano, ^liss Goodrich and Miss 
Thompson were appointed a committee of three to present the 
plan for the proposed school, but its outline and details as 
completed followed Miss Goodrich's suggestions. 

The Army School of Xursing was made a Division in the 
Surgeon General's office. On Muy 27, lOlS, Miss Goodrich 
was placed at its head with the title of Dean and was directly 
responsible to the Hospital Division. 

In a meeting of the Committee on Nursing, Council of Na- 
tional Defense, Septeniber, lOlS, it was dwided "that a com- 
mittee \h* apiwintwl by the chair ti) develop a pn»gram for the 
participation of the civilian hospitals in the training of pupil 
nurses or hospital assistants for army service in affiliation with 
the Army School of Xursing." The members of this oimmittcMS 
were: Jane A. Delano, Annie W. G<x)drich, Lillian Clayton, 
Ella P. Crandall, Dr. S. S. Goldwater, Colonel W. IT. Smith. 

The first meeting was held on September 20, 1018, and the 
minutes for that meeting embody the coordination plans ar- 
rived at between the ]?ed Cross and the school. From them 
have been taken only those details which illustrate this adjust- 
ment for smooth working and the avoidance of duplication; 

Minutes of the Special Committee 

Appointed to develop a program for participation in civilian 
hospitals in the training of pupil nurses or honpilal aspistajitii 
for Army Service in affiliation with the Army *School of 
Nursing. Council of National Defense, Washington, U, C, 
10;30 A. M, 



MOBILIZATION 



287 



September 20, 1918. 

The chairman state J the purpose of tlie meeting and asked 
for suggestions from those iu attendauce. Upon request. 
Miss Goodrich, Dean of the Army School of Nursing, pre- 
sented a suggestive plan of affiliation of civilian schools with 
the Army School of Nursing. . , , Miss Delano urged the 
importance of enrolhiig alliliated students for military duty 
through the Hed Cross only and not directly into the Army 
Nurse Corps in order to secure n permanent registration of 
future nursing forces; she also urged the enrollment in the 
lied Cross of all senior classes pending graduation, subject 
of course, to the individuals who wish to be enrolled. 

Miss Delano raised the question of enrolling hospital as- 
sistants through the Red (.Voss. While this matter was gen- 
erally felt not to be pertinent to the main issue and should 
therefore be left for consideration with other details of de- 
velopment, the chairman ruled that in the absence of ob- 
jections, Miss Delano's urgent request for its consideration 
at this time would be granted. 

Dr. Ooldwater moved as followH : "Resolved that civil hos- 
pitals which have the necessary facilities be encouraged to 
arrange for the training and use of hospital assistants accord- 
ing to the plan and qualilications of the Army School of Nurs- 
ing that such hospital assistants should be enrolled through 
the American Red Cross with the understanding that they 
will accept service as required either in hospitals in M'hich 
they are trained, with the American Red Cross, or in the 
Army Hospitals/' The motion m'hs seconded by Miss Nutting 
and carried unanimously. 

5Iiss Delano moved that the students in schools for nurses 
contemplating affiliating with the Army School of Nursing 
be given an opportimity to enroll as Red Cross Student 
Nurses, such enrollment to constitute graduate enrollment 
upon completion of this course, and the recommendation of 
the dean of the Army hospitals. The motion was seconded 
by Miss Nutting and carried. 

Miss Nutting made the following motion : "Having heard 
from approximately three hundred training schools of the 
conntry and approximately two hundred having expressed a 
desire to affiliate with the Army school, this i-ommittee ap- 
prove* in general the plan of afRliation as presented by Miss 
Goodrich, Dean of the Army School of Nursing, with the 
understanding that it is subjei't to further modifications as 
later experience may make advisable." The motion was 
seconded by Miss Clayton and carried. 



288 HISTORY OF AMERICAN RED CROSS >rURSING 

To provide for the public health nursing iufltruction of stu- 
dents of tiic Army sehoiil at HcMiry Street Settleineiil, Nt'W 
York City, the lied Cross through the New York Conuty Chap- 
ter contributed $40,000 for euch of the school years of 1019 
and 1920. A provision of $00(»0 was also made by the Ameri- 
can Red Cross in San Francisco with the University of Cali- 
fornia for the Amiy School at Letterniun General HoHpital. 
The full details of these gifts are found tu tlie Annual Report 
of the American Red Cross for the year ended June 30, 
1921. 

In compliance with a request from the Surgeon General 
of the U. 8. Army, the Executive Committee of the American 
Red Cro88 on January KJ, VJ21, authorized the chairman to 
make availahio for the New York County Chapter funds not 
to exeee<l $40,000, or such part thereof as nii^lit be necessary 
to cover assistance through the New York County Chapter 
to nurses in the Army School of Nursing taking the course 
in public health nurning at the Hour)' Street Settlement and 
Teachers College, New York City. This was in continuation 
of aflsistunce which hail been givcu througli the same channel 
and under tlie same conditions during the previous year and 
was to come, if feasible, from funds which had been set aside 
by the National Orgauization for financing the work of the 
New York County Chapter by special arrangements with this 
Chapter. Up to December, 1920, eighty students had taken 
the course, and seventy-nine more to June, li>51. 

Schnlarships amounting to $(>000 for 191!)-20 were given 
to Major Julia ('. Stimson. Dean of the Army Nurse Corps 
to be nped for thirty students of the Army School of Nursing 
at the Ijetterman (ieneral Hospital for incidental expenses 
in connection with the course in public health nursing at the 
University of California; $2250 were given in March, 1921, 
and $2280 in August, 1921, for the same purpose. 



The Army whool had an immcdiato and pronounced sno- 
cesa. The foremost civilian training schools for nurses affiliated 
with it and by the date of the Armistice, it had 10f>9 students 
on duty in twenty-five hospitals, 567 more awaiting assign- 
ment and a total of 10,089 applications filed. One of the 
vahied pieces of work accomplished by the IJcd Cross Bureau 
of Information for Nurses, established during demobili/.ation, 
was to refer to civilian schools of nursing these 507 accepted 
candidate's for the Anuy school. 




MOBILIZATION 



289 



Following the plans for the coutinuance of the Army 
lool,** it was mailo a permanent school in July, IVIlO, and 
iss Goodrich then rtrtnrned to her work at Teachers College. 
She was succeeded by Julia Catherine Stimson as dean. 

By the early part of lOlS the 8»irgeon General's office had 
given out the word that fifty tliousand graduate and stiident 
nurses must be enrolled and available during the period up 
to January, 1919. 

The Red Cn>s8 Nursing Service had already taken definite 
steps toward enrolling a quota of five thousand nurses that had 
been asked for by the Surgeon General's office for the period 
ending June 1, 1918. On March 14 Miss Delano reported these 
steps as follows: 

A letter to the enperintendents of 3000 or more training 
echools urging tiiein to incre^ise the supply of nurses for 
immediate service by advancing the date of graduation. 

A letter to the Iwards of registration urging early ex- 
aminations and as prompt action u[>on papers as possible. 
(The provisional enrollment has been authorized to accept 
Burses pending the return of the result of their examination.) 

A special letter to the State Nurses' Associations explaining 
the necessity of close cooperation with the Divisional di- 
rectors. 

A circular letter was also sent to the ten thousand sub- 
scribers of the Journal calling attention to the need of 
nurses, the War Risk Insurance and the necessity of registra- 
tion. 

A small enrollment leaflet has been sent out in the general 
correspondence of the Divisional directors and also in the 
correspondence of the Americati Journal of Nvrsing and to 
the subscribers. 

A special letter from the director oF the Bureau of Field 
Nursing was also sent out to the superintendents? of 2000 or 
more training schools urging them to organize training school 
units from the senior class and the alumnie associations, 



Xow in view of the greatly iuereused requisitions the Red 
Cmea decided to conduct an intensive "drive** for nurses be- 
tween the dates of Junt- 3 and July 17, 1918. Miss Delano 
wrote in April in the Journal: 

•"No art of Congress authori^iIlg the Anny School of Nursing has 
b«t*n piiBsc>d to datv f 11121). It in continU(»l as a group of *oiviliKn em- 
ptoyeea of the Medicnl Department/ " 

J, C. STIUSOff. 



290 HISTORY OF AMERICAN RED CROSS NLHSING 

The survey which has recently been made [by nursing so- 
cieties] indicates that there are not more than f)5»00() regis- 
tered nurses in the United States. If we are to meet the 
needs of the Army aiid the Xavy with registered nurses alone, 
it will be necessary to withdraw not far from fifty per cent 
of the total number of registered nurses. Even though we 
include all graduate nurses who are not registered, placing 
the total at about one hundred thousand, at least thirty-three 
per cent of the entire number must be secured, if we are to 
provide nursing care for our Army and Navy. 

In view of these figuren it seems evident that a special 
campaign for the enrollment of nurses must be undertaken, 
not only to bring to the nurses the great need, but to insure 
the cooperation and assistance of the public and physicians 
of the country as well. It does not seem fair to place upon 
the nurses the entire responsibility of a decision. We believe 
that the community must share with the nurse the responsi- 
bility* for her withdrawal from the community and protect 
her as far as posyilde from too great a (inancial sacrifice. The 
Eetl Cross is therefore taking steps toward organizing a 
definite campaign which we hope to undertake in the early 
spring. 

A special committee has been appointed by the chairman 
of the National Committee on Red Cross Nursing Service, 
representing the three national organizations of nurses^ to 
aid in preparing the publicity material and in carrying out 
this special campaign. The representatives of the three or- 
ganizations are Katharine DeWitt. secretary of the nurses* 
association and assistant editor of the American Journal of 
I^ursing: S. Lillian Clayton, president of the National League 
for Nursing Education ; and Ella Phillips Crandall. executive 
secretary of the National Organization for Public Health 
Nursing and of the Committee on Nursing of the Council of 
National Defense." 



The Surgeon General himsolf wrote an appeal to the Red 
Cross in behalf of the drive. He said : 

May 25, 1918. 
I am informed that on the third of June it is the intention 
of the Red Cross to start a Drive for Nurses for the Army. 

The American Red Cross is a great recruiting agency for 
Army Nurse? and through this agency I wish to appeal to the 
nurses of the country to enroll for service in the Nurse Corps 
of the Army. 
**R«I Crona Department, .imericnn Journal of yurting, April, 1018. 



MOBILIZATION 



291 



The need of a great number of nurses is acute, and any 
assistance the Red Cross can render the War Department in 
obtaining? for the Army Nurse Corps the number of nurses 
required will be a service to the country. 

(signed) William E. Goroas, 
Surgeon General, U. S. Army. 

The machinery used for the drive was very largely the organi- 
zation of the Ked Cross Chapters, which had taken on vast 
dimensions under the war stimulus. In August, Miss Delano 
summed up the methods used for, and the results obtained by, 
tlie drive: 

It was decided to call upon the Cliapters of the American 
Red Cross to cooperate in securing the required number (it 
may not be generally known to the nurses of our country 
that the Red Cross now has a membership of more than 
22,000,000 adult members and *J,000,000 junior roembera, 
rith 3885 Chapters, 14,208 thapter-brauehea, and auxili- 

ies) ; in order that the vital need of our country for nursing 
•rvicG might be brought to prpctically every graduate nurse 
in the country. It was understood, of course, that the formal 
applications for enrollment should come in through the usual 
committees on Red Cross Nursing Service and the Division 
officers. 

This was a new departure, and the results have confirmed 
us in the belief that our nursing service will be greatly 
strengthened by this close contact with the general member- 
ship of the American Red Cross. We have found the Chap- 
ters throughout the United States most cooperative and 
anxious to assist, and we feel that the Nursing Service of 
the Red Cross will be permanently benefited by the relation- 
ship which has been established in this way." 

Results of the **Nurse3' Drive" can best be appreciated by a 
brief comparison of enrollments during the fiscal year of 1017- 
1018 and the subsequent five months terminating N'ovember 
1, 1918. No method for determining the exact returns of the 
drive was attempted, but the unparalleled increase in enroll- 
ment over previous months was due in large part to this pub- 
licity campaign and to the unceasing labors of local Chapters 
and committees on Red Cross Nursing Service. 

During the fiscal year of 1917-1918, 11,213 nurses were 
enrolled, an average of 817 a month. The impetus of the 

Dcluio in American Journal of A'umtij^, August, 10]8. 



292 HISTORY OF AMERICAN RED CROSS NURSING 



"nurees' drive" was first felt in June, 1918, when enrollment 
increased from approximately 000 to 1500 nurses. During] 
July 2G64 nurses were enrolled and in Augiist 2700, the highest 
figure reached during the war< For the five months beginning 
July 1 and ending December 1, ll,llJ> nurses joiued the Red 
Cross reserve, an average of 2220 nurses a mouth — an in- 
crease of almost 300 per cent over previous months and a 
number equal to the entire enrollment in 1917. ^m 

By the autumn many Division directors reported that they^l 
had reached and passed their quota, but the cessation of hostili- 
ties then made it needless to enroll further members. In speak- 
ing before an audience of nurses u year later. Miss Noyes gave 
some interesting details of the immense and fatiguing hibor 
involved in the enrullmeut and the intensive *'»drive." Alluding 
to Miaa Delano she said : 



i 



Working with her at National Headquarters for over two p 
years, it was my privilege to sec something of her devotion ^H 
to the cause which ^he served. Many times when we reached ^^ 
the end of a weary day's work and the pressure seemed almost 
more than human [wwcr could stand F have heard her say, 
when asked if she were tiretl, **Well, I suppose it is no harder 
for us to die at our desks than for the boys to die iu the 
trenches." I 

When the Armistice was signed the papers of six hundred 
nurses were in the War Department ready for assignment and 
several thousand more had given their date of availability 
between that time and January 1, 1919. With the addition 
of those who had entered the Army (3000) and the Navy i 
Nurse Corps (500) direct, the total number of nurses in 
service at the time the Armistice was signed was, as nearly 
as it is pOFsible to estimate, about 25.000. 

The Army had osked for the phenomenal number of 25,000 
nurses by January 1, 1910, and 50,uoo l)y the first of June, 
1919. fJreat anxiety had been felt on the part of those who 
were working doBe to the scene, as to the possibility of 
meeting this demand and at the same time meeting tha 
civilian needs of our Allies and of our own countr}*. 

Figures Rpeak for themselves. The response by the nursei^ 
to the call of the colors is a conclusive refutation of any*) 
criticism that they failed to meet their war obligations, ft] 
is easy to speak of *.i0,')00 nurses?, but impossible for anyone 
to picture the tremendous amount of work in connection with 
the enrollment and assignment of these to service. The or- 




MOBILIZATION 



293 



I 
I 



ganization at Red Cross Headqnaiiers had to be developed 
with the utmost regard for lomplote cooiw ration. 

In order to prepare a nurse fur duty with the military 
estiihlishnieut it was frequently noceBsary to ?ond many 
communications both by letter and telegram baik and forth 
before the nurse became fiuftieiently ntahle to refer her papers 
to the War Department. This wat- noeespary lest Home ncridnnt 
occur whereby the trans|>ortatir>n which was insued from 
WttFhington might go to an addretiK at wliirh th(» nur^ could 
not be found. To prepare a nurse for service directly under 
the Red Cross was even more dil!icult, a« the prei-autions 
adopted by the State and War Dt-partmeutM before a passport 
could be issued were extremely complicateil. Investigations 
through tlie Militar)- Intelligence Department for loyalty were 
required for everyone, and it frequently took weeks and oven 
months to secure the passport of a nurse for overseas duty 
with the civilian population in those counlried that were 
turning to the Reil Cross for help. I mention thus briefly 
some of tlie purely routine proi'cdurei! tliat held the individ- 
uals in charge of the various bureaus under the Department 
of Nursing at their desks from early morning until late at 
night, holidays and Sundays, from the time diplomatic rela- 
tions with Germany were broken until several months after 
the signing of the Armistice." 



The Student Nurse Re8or\'c campaign, like that for the 
creation of tho Army School, was stimulated electrically by the 
rery high figure issued fnun tlir Surgeon (lencrars othcf curly 
in 11>18, in estimating the pndiablc uce<l for nurges and assist- 
anta. A formal statement of the launching of the campaign is 
found in a letter from Dr. Franklin Martin, member of the 
Advisory Commission, Council of Xational Defense! to Mr. 
Henry P. Davison, It was dated June 27, 1918, and ended 
with the words ; 

. , . Immediately following these reports. Miss Patterson, 
director of the Woman's Committee, Council of Natinual 
Defense, presented an outline of a campaign, as extensive 
in ita scope as that of the Red Cross enrollment of nurses, 
for recruitinfj 25,fK)0 students for both military and civilian 
hoHpitals. which her (rommittee is about to lauiu-h at tlie 
request of the Committee on Nursing of the Council. As 
yotj know, the Surgeon (ieneral's oflice. the Red Cross and 
the General Medical Board are cooperating. 

■Tlw Hvd Cross NurBinft Service, Twenty-ftltii Aoniul Hc[>ort, Na- 
tiooal LMgue for Nuralng Education, 1019. 



294 HISTORY OF AMERICAN RED CROSS NURSING" 

The Red Cross cooperated by circularizing all of its Chaptera, 
by opening Chapter offices as recruiting centers and by assign- 
ing Red Cross workers to help carry on the campaign. The 
publicity material was the work of ilisa Nutting's committee 
and was submitted for approval to the Publicity Department of 
the American Red Cross. An example of the material follows: 

The Government is now calling for 25,000 young women 
to join the Tnited States Student Nurse Keservc and hold 
themselvos in readiness to train for service as nurses. 

Age: The call is for women between the ages of nineteen 
and thirt}-iive. 

Qualifications: Intelligent, responsible women of good edu- 
cation and sound hcaltii are wanted — the pick of the country. 
A college education is a valuable asset and many hospitals 
will give credit for it. Credit will also be ;ziven for a special 
scientific equipment or for preliminary training in nursing, 
such as that given in special courses now being conducted by 
various colleges and ficluKils. 

Knrolhnent: Women will be given an opportunity to enroll 
in the United States Student Reserve in any one of three 
ways : 

1. As engaging to hold themselves in readiness until April 
1, 191I>. to accept assignments to nurses' training schools in 
civilian hospitals. 

3. As desiring to Wome candidates for the Army Xursing 
School recently established by authority of the War Depart- 
ment, with branch schools in selected military hoiifpitals. 

3. .As engaging to hold themselves in rentliness until April 
1, 1919, to accept assignments to either a civilian training 
echool or the Army Nursing School. 

The Student Nurse Reserve campaign was a work of infinite 
detail and in its course many puzzling and exceedingly com- 
plicated obstacles of an educational or economic nature were 
met with. Its results shed light upon our o\^ti professional 
problems and may even be found helpful in other countries. 
ror this reason some parts of the final report are here given: 

The entire program as outlined was dependent upon keep- 
ing up a large, steady supply of candidates of superior quality 
for both our civil training schools nu<l the Army scIkh)!. and 
it was soon evi<]ent that the latter would arouse great interest 
and attrat't many desirable applicants. . . . 

. . . There are many practical ditTiculties to be overcome. 
For example many grammar school graduates are not eligible 



MOBILIZATION 



^95 



in the st^te in which they eulinted^ and they may he unable? 
to bear their expenges even to an adjacent slate. Thus while 
vacancies still ejcist and applicants await appointment, it ia 
often impossible to accommodate either. The large number 
of reassignments are due chiefly to three causes, i.e.: (a) Lack 
of information on the application forma regarding denomiua- 
tional preference, (b) Inability of the candidates to meet 
the e.xpenjies of travul and equipment, (c) Direct recruiting 
in localities, in many instances, into their own schools in- 
stead of through this committee. 

Disappointing delays have arisen, due largely to four 
causes, i.e.: (a) Incomplete application forms, (b) Incom- 
plete and often inaccurate information regarding age and 
educational requirements and the number of students needed. 
(c) An utter lack of precedent for or experience in such a 
piei'e of work, (d) Inadequate staff of workers. 

However the fact remains that, whereas in June, July and 
Augrufit. many hospital training schools were sutTering for Uuk 
of students, there are now thirteen states (this number was 
later increased to seventeen), in which needs of all schools 
have been met. 

As the need for large niimhers was urgent and immediate, 
and as fourteen state laws called for only grammar school 
education, the committee thou^'ht it necessary not to exL-Uule 
Buch applicants in the first drive. I^ater two years of high 
school was made the minimum requirement. By common 
consent, the thousand and more ineligible candidates were 
urged to accept positions as attendants or to enter for train- 
ing as attendants in l;ospitals for tlie mentally eick, children's 
orthopedic hospitals and tuberculosis sanitaria, institutions 
in which an almost tragic need of workers existed. Many 
letters from these institutions have expressed the greatest 
appreciation of and gratitude for the connnitteo's olfer of 
assistance. Unfortunately very few of these young women 
were willing to accept such service, 

A little less than thirty-three per cent of the candidates 
were referred to the Army School of Nursing and the re- 
mainder to civilian schools, each candidate having been given 
the privilege of choosing which she would enter. Even though 
many states failed to recruit the necessary numbers to fill all 
vacancies within their schools, though a considerable number 
of candidates proved ineligible, and though there have been 
other inadequacies as the work proceeded, (»f wliich tl»e com- 
mittee has been constantly aware, there is ample evidence 
that the campaign met a very great need at a time of both 
local and national emergency. A c*omplete report of candidates 



296 HISTORY OF AMERICAN RED CROSS NURSING 



recruited and assigned has been prepared by states and by 
schools and copies sent to each state.^^ 

The campaign was closed on December 15, 1918. Some 14,000 
or mon; applications were dealt with and of these, 13,800 odd 
candidates were enrolled for entrnnoo into schools for nurses. 
Those who met all the requirements numbered 5380 and were 
assigned to the x\nny school. To tlie civil schools of nursing 
5185 were directed. The others were on a waiting list. Much 
was learned of the hospital.s. In one state alone, for example^ 
twelve hospital training schools were dropped from the ac- 
credited list, as undesirable for the training of Student Nurse 
Reserve candidates. 

The instructions and demonstrations to volunteers for mak- 
ing surgical dressings for the Army were first given by Red 
Cross nurses. As the work spread over the country, it was stand- 
ardized by regulations from the Ntirsing Service in consulta- 
tion with Army 8Urg«^»ns. It was estimated that S.00i»,000 women 
working in Red Cross Chapters made 253,00(1,000 surgical 
dressings betwe<m April 6, 1917, and October 1, 11*18, while for 
twenty months ending February 23, 101!), the number was 306,- 
90fl,750. There were more than 30,000 workrooms, where asep- 
tic oimditions were maintained as in the surgical workrooms of 
a hospital. In addition to the dressings, many millions of other 
articles of clothing and hospital equipment were made. 

When the Mercy Ship sailcKl at the outbreak of tlie war, a 
small group of Wasbingtonians went immediately to work to 
prepare surgical dressings for the Red Cross. Admiral M. E. 
Mason, chairman of the District of Colunibia Chapter, ap- 
pointed a committee composed of Abbie R. and Kdith M. Mc- 
Cftmmon, Annie Power and Mary Randolph to develop this 
activity. In a little shop on Eleventh Street, donated through 
the generosity of Mr. M. A. l^^ese, they opened on December 1, 
1914, the first official Red Cross workroom — the parent of 
hundreds of supply depots, later set up in libraries, railroad 
terminals, department storea, clubs, Sunday School rooms and 
remote country schoolhouses. 

At a meeting of the National Committee on Red Cross Nurs- 
ing Service, held June 20, 1917, in New York City, Miss 
Delano descriU-d the work of this first committee on surgical 
dressings : 

■• Rpport of the Committee on Nuraing, Ocneral Medical Board, Council 
of N'tttiuiml VivlcntM, April, 1919. 



MOBILIZATION 



297 



A circular was issuefl in 191") and distributed generally to 
Red Cross Chapters. This was used as a basis of work until 
the publication earlv in 11*10, of a second pamphlet intended 
for United States War Ifelief. At this time, the standard 
boxe^ were also adopted anil thnir contents defined. In order 

maintain a definite standard for the preparation of these 
'dressings, we rciilizeti thnt n etnirsp of instrnction must he 
'Adopted. A plan was acc'ordingly worked out and appoint- 
ment cards authorizing their recipient to act as inntructors, 
were issued to thone reconiniended for this work by the com- 
mitteee in charge of our surgical dressing workroom. 

During the spring of 1916, classes were organized not only 
in cronnection with our Chapters but in cooperation with the 
Woman's Section of the Navy League. It may be interesting 
to state the method followed in the adoption of standard 
drossin;::^. In cooperation with the Supply iJepartmeut of 
the Red Cross, I visited various hospitals in Boston and 
elsewhere, such as the Boston City Hos])ital and the Presby- 
terian and Belle\nje Hospitals in New York City, and selected 
imples of their various dressings, operating-room gowns, 
helmets, etc. We then secured complete sets of dressings from 
the Army and Navy Hospitals, so that we had typical dress- 
ings from about twelve diffen-nt hospit-als. 

A confereu(*e was then hchl between stirgeons and nurses 
from the Army and Navy, Red Cross personnel and several 
nurses who had had experience in Europe. The various 
reesings were examined and those which seemed common to 
a majority of hospitals were selected. A sample box was pre- 
pared and submitted to directors of unittf such as Dr. Crile 
of the Lakeside Hospital in Cleveland. S!ight changes were 
made on their suggestions, and the so-called Ilcd Cross dress- 
ings were adopted. 

In September, 1916, the responsibility for hospital sup- 
plies was turned over to Miss Noyes. She and Dr. Richards, 
B representative of the Navy, revised the supply circular, but 
DO radical changes seemed necessary. 



Thron^out the winter inontlis of 1916 and 1917, the in- 
tCTMt of women in all parts of the United States in the prepa- 
ntioxi of Burgical dressings developed l)cyond tlie capacity of 
i oenCnd office at National Headquarters to handle. Miss 
Noyea bad prepared a special course in the making of these 
dressings ami also a second course, after satisfactory comple- 
tioo of wLieh the student was certified as being able to act as 
fta instructor for other classes in the preparation of dressings. 




298 HISTORY OF AMERICAN RED CROSS NURSING 



Hundreds of certificates, one for the general course and a second 
for the instructor's course, went out under Miss Ncyes* signa- 
ture to all sections of the country and became the keystone over 
which the Red Cross workrot^ius sprung up in schoijlhouses, 
churches, clubs and industrial centers. 

Before a woman was certified as an instructor, she was re- 
quired to submit a sample box of the various types of surgical 
dressings. No sooner had iliss Noyes examined aud cleared 
her desk of these samples than the i[ail Division would send 
up a hundred more. The top floor of the *'^rnrble Palace" 
billowed with cotton and gauze. Vashti Burtlett was the first 
nurse to assist Miss Noycs; later, volunteer nurses from Wash- 
ington lightened the bnrden of the overtaxed director and lier 
assistants. Among these was Mrs. Charles Silliman (Mary V. 
Lee, Johns Hopkins), After examination, these innumerable 
white pads and neatly-folded bandagea were passed on in 
elotbes-basketa to Mrs. Theodore W. Richards, who sorted out 
the perfect articles and packed them into complete model boxes 
to be returned to Chapter workrooms. 

To zealous women waiting impatiently in Rod Cross Chap- 
ter and Branch headquarters for their certificates, the Nursing 
Service may have seemed over-exacting in their insistence upon 
perfect dressings. Sharp adherence to standards resulted, how- 
ever, in great economy of materials and time. Overworked 
nurses in evacuation and base hospitals, moreover, could not 
stop to refold a pad whose ravelled edges might result in 
discomfort and danger to their patients. Great pressure was 
being brougl»t to bear at this time upon the Nursing Service 
to change the types of dressings to suit the preferences of in- 
dividual surgeons. The aim of National Headquarters had 
always been to prepare a type of dressing which anyone could 
use. As this standard hod been reached after conference with 
leading authorities of the Army, the Navy and civilian insti- 
tutions, Miss Noyes turned a polite but deaf ear to protesting 
physicians who came to interview her. After the Nursing 
Service had given over this work to the Women's Bureau, a 
special committee went to Europe to study the entire question, 
and the Red Cross models were later changed. 

On June 23, 1917, Miss Noyes wrote as follows to Col. Kean : 

Since January 1, the work of the Surgical Dressings and 
Garments Division of the Bureau of Nursing Service has ex- 
panded with great rapidity. Thousands of inquiries are com- 



MOBILIZATION 



299 




» 



ing to us from Chapters, branchps of Clinptors. auxiliaries, 
groups of worker:? and individuals who are interested in the 
preparation of surgical dressings and hospital garments. 
Every new Chapter and auxiliary at once desires this particu- 
lar work. Although circulars of information and detailed 
directions are sent concerning the organization of clnssos and 
the manufacture of dressings and garments, questions are 
constantly arising which must be referred to an authoritative 
faead^ 

We have divided the country into eight districts — Boston, 
New York City, Philadelphia, Baltimore. Cleveland, Chicago^ 

lorado Springs and San Francisco, for distribution of 
pie boxes of dressings, patterns, emblems and iuforma- 
tion. As the pressure upon these Chapters has increased, it 
hns seemed desirable to authorize other distributing centers 
and the following are preparing to qualify as such — Atlanta, 
Kew Orleans, St. Louis, Minneapolis and Seattle. 

It would he safe to say that workrooms have not only 
been established in all of our cities, but towns and country 
districts have developed in the same direction. The following 
workrooms stand out conspicuously as models of cfTiciet^cy: 

Xew York City as developed under Mrs. Belmont Tiffany. 

Chicago as developed under Mrs. John (Jla^s. 

Washington, D. C, as developed under Mrs, T. W. Richards. 

Baltimore as developed under Mrs. Thos. S. Cullen. 

Cleveland as developed under ^Trs. E. S. Burke, 

There are many others equally proficient. 

The statistics appended show the status of the work at the 
present time: 

Since December I.t, 101 fi. 

No. of conipletetl surgical dressings classes 330 

No. of pupils qualified 4799 

No. of enrolled Red Cross nurses qualified 166 

No. of lay instructors quali Tied 363 

No. of sample boxes sent from this ofTice 451 

You will note that 15(» FJed Cross nurses have been qualified 
and enrolled as instructors in this course, but we believe that 
the instruction and management of workrooms could safely 
be entrusted to our qualified workers and lay instructors. 
Red Cross nurses are required for the more imjxtrtant work 
of craring for sick and wounded soldiers and sailors. 

provide administrative channels through which this trana- 

oould be effected, the Executive Committee established 

Ij 2, 11*17, under the Department of Chapters, a bureau 




300 HISTORY OF AMERICAN RED CROSS NURSING 



through which all women's activities for the Red Cross (other 
than professional nursing) should be recognized and developed. 
The vice-chairman also appiiuUHl a Woman's Advisory Com- 
mittee, eonsisting of the following members: Mrs. William K, 
Draper, chairman; Miss Mary G»H)dwillie, vict»-chairmau ; 
Miss Mah«'l T. Boardman, Mrs. Joseph M. Cudahy, Mrs. Frank 
V. Hamniar, Mrs. E. H. Harriman, Mrs. George Wharton 
Pepper, Mrs. Leonard Wood, Miss Lavinia H. Newell, Mrs. 
William 11. Ooeker, Mrs. Preston S. Arkwright, Mrs. August 
Belmont, Mrs. J. Randolph Coolidge, Jr. To the Woman's 
Bureau, of which Miss Florence Af. MnrsliHll was director, 
was immediately delegated all work connectcfl with surgical 
dressings, hospital garments and ivfngee cliitliirig. 

In the Red Cross Annua! lieport for 1017, Miss Delano 
summarized the benefits derived from this transfer: 

This reorganization served two puq>ose8; it released a 
large number of nurses, who have been acting as instructors 
in i^urgical dressings and hospital supplies, for other service, 
and it marshaled the forces, not only of women volunteers, 
who were fitted to become instnictors, but of the great army 
of volunteer workers throughout the country just when the 
emergency demanded such a realignment. It left the Nursing 
Service free to deal with its purely professional duties. 

During the period in which the United States was at war, 
several surveys of the nursing profession were made in order 
to obtain a working estimate of the nursing strength of the 
country. Imme<liately after the declaration of war by this 
countr^', the National Committee on Red Cross Nursing Serv- 
ice, as a first step, carried out a preliminary classification of 
itfl own enrolled members under the heads of nursing special- 
ties. Miss Delano wrote:'* 

With tl»e de<'laration of war, there was a decided increase 
in the application of nurses for enrollment with the Red 
Cross. The enrollment from January 1 to October 31, IH]?, 
has been over 7000. giving us a total enrollment on Octobet 
31 of 14,r»28. To meet the demands for nurses with special 
training, n clupsified list of the entire enrollment has recently 
been made and special groups of nurses selected for the fol- 
lowing 8er\'i(cs: pcdintric work; orthopedic work; nen'oua 
and mental diseases; head and neck surgery; contagious die-, 
eases; public health work; eye and ear work. 
* Eighth AnnunJ Report^ American Red CroM. Dec'cmber, 1917. 




MOBILIZATION 



301 



Further than this, the firat census of the entire nursing re- 
sourees of the country was set on foot early in June, 1917, by 
the Nursing Department of the Red Cross. This consisted 
of an exhaustive survey of all the hospital training schools in 
the United States. It was Miss Delano^s own idea and was 
carried out entirely under her direction by Miss Deans, whose 
exceptional knowledge of training schools and nursing stand- 
ards made her an unusually cipable worker on such lines. This 
survey was completed by August 18, 1017. 

The 8ur\'ey was conducted by first writing to the Boards of 
Examiners of the different states, to ask for complpte lista of 
all accredited and uon-acert'dited training schuuls of tho state. 
The Boards of Examiners replied with promptitude and act!u- 
racy to this request and the survey was then pushed further 
by sending a quest ioiiuairr to all the training sehools thus listed, 
asking f(»r careful and detailed statements of their iHlneatii>nal 
etaiidards, practical services and nursing res<)ure<'a. An alpha- 
betical list by states was tJien made showing all the hospital 
training schools by name and address. From the replies re- 
ceived to the questionnaire the training schools wert* classified 
under six headings. 

Prior to the war, the Rod Cross Nursing Service had simply 
listed training schools whose graduates were eligible for Red 
Cross enrollment; where supplementary training was neces- 
sary, this information had been placed upon the tile card. But 
now the classification was as follows: 

Class A. Schools which meet Red Cross requirements. 
Class B. Schools whose graduates are of a high grade and 

the training general in eiuinu-ter, including men, 

hut daily average uuniher of patients helow fifty. 
Class C. Schools which are small but training goad as far 

as it goes. 
Class D. Schools connected with private hoflpitals having 

alFiliation with general hospital^;. 
Class E. Schools not accredited but likely to be. 
Class F. Sciiouls which are undesirahle. 



The care and thoroughness with which this survey was con- 
ducted, as well as the helpful readiness of Miss Delano's office 
to point out ways of raising standards, may be deduced from 
the following illustrative selections from the letters sent out 
from and received by the Department of Nursing: 



802 HISTORY OF AMERICAN RED CROSS NURSING 

(Letter Seut to Boanls of Examiners) : 

The Red Crosj* is making every effort to anticipate the 
demaTidH wliirh will he made for nurpcs not only in Europe, 
but in our own t-ounlry slioiild the war be of several years' 
duration. 

With this in view wo are asking? for the cooperation of the 
American Nurses' Association, state asfioc-iations of nurses, 
State Boards of Examiners for Nurses and hospitals to assist 
us in meeting all emergencies which may arise. 

We are enclosing a list of schools accredited by your State 
Board of Examiners, together with a questionnaire to be used 
in supplying the information we require, also a copy of the 
requirements for enrollment in the lied Cross. 

Would it he possible to conduct special examinations, as 
many nurses are eligible ns soon as graduated, but have to 
wait several months to take this examination? The Red 
Cross would greatly regret the necessity of lowering its stand- 
ard for enroHinent without this roquin'ment of registration. 

Could you furnish uj* with a list of nurs^ea as soc)n as they 
have passinl their examinations, in cnse there siiould be an 
unavoidable delay in issuing thrir certificates? 

it is absolutely essential tluit we Imve definite information 
on file of all the nurses in the country, and believe there is 
no one in a better position than the Buunl uf Examiners to 
funiisji the probable number of nurses available in its state. 

It may be ne<?ossnry to sui)plcment the nursing service both 
iu militir)^ and civil hospitals with Momcn who have had at 
least the course in Elementary Hygiene and Home Care of 
the Sick. This theoretical instruction should l>e supple- 
mented by 72 hours in a carefully selected group of hospitals 
and we shall appreciate your interest in suggesting training 
schools which can be safely entrusted to give this instruction. 

Assuring you of my sincere appreciation of your efforts in 
behalf of the Red Cros&r believe me, to be^ 

Yours very truly, 

(signed) Jane A. Delano, 

August 4, 1917. 
My dear Miss : 

I appreciate greatly your letter received this morning and 
your willingness to take for pust-gniduate work w)me uf the 
registered nurses who are graduates of the hospitals some- 
what under our required average. 

We are interpreting this requirement a little more leniently 
and hnve decided to accept s<'h*M»ls rei*ommendoil by Boards 
of Uegistration as giving a suHiciently thorough training to 




MOBILIZATION 



303 



qualify ita graduates for Red Crosfl service. A number of 
other echoolE have expressed their williiignesB to provide 
some post-graduate work for their nurses, and we anal! be 
rery glad to accept the four months' eJtperience in your hos- 
pital for such nurses as you may recommend for service. 

Assuring you of our sincere appreciation of your service, 
believe me^ 

Youra sincerely, 

(signed) Jane A. Delano, 



My dear Miss 



August 29, 1917. 



Your second list of the small schools in 



with 



other information received for which I thank you. 

We have a large number of applications from nurses grad- 
uating from small schools who might he eligible for enroll- 
ment, providetj tl)ey have some subsequent experience or 
training and 1 should be glad to have the names of the 

schools in which offer post-graduate work for 

nurses. 

We are urging these nurses that do not meet the require- 
ments to take this subsequent training and recently have heard 
that the Hospital of and the 



Hospital of 



are offering special post-graduate work 



to graduatpf* who do not meet the requirements of the Ameri- 
can Red Cross. 

Thanking you again for your helpful information, I am, 
Yours very truly, 

(signed) Jane A. Delano, 

December 7^ 1917. 



In \'iew of the tremendous demands now being made upon 
us for nurses in the cantonment hospitals, we arc waiving 
the requirement of atHliation with the American Nurses' As- 
sociation. I feel sure tliat this requirement can be far better 
aacrificed than that of registration, t>r the character of the 
school from which the nurse graduated. 

Will you therefore forward to Division office at once any 
papers which you are holding pending affiliation, securing 
at the same time their physical examination blanks together 
with a reliable address and a statement concerning their 
arailability for service? Will you also announce to the nurses 
in your community that the applications of those meeting 
other requirements except affiliation will be considered and 
forwarded to Washington, thus stimulating increased en- 
rollment? 



304 fflSTORY OF AMERICAN RED CROSS NITRSIN( 

I would suggest, ill view of the fact that practically all of 
the cantonment hospitals need additional nursing personnel, 
that you rvquest each member of your i-ommittce to secure 
at once the enrollment of as many nurses as possible. Kindly 
ask the nurses s*?curing ihcite enrnllraentj* to write their names 
and addretiij^es at the top of Uie applications. m> that as the 
papers come in we may be able to give due credit on a chart 
which we are preparing, to the various individuals and com- 
mittees. 

The organizations of nurses in this country have assumed 
a definite responsibility for senice in time of war, a far 
greater responsibility than re-sts upon any other group of 
women, and I feel sure that if the need is brought to them 
clearly, they will not fail at this time. If they do, we 
shall be responsible for any breaking down of nursing stand- 
ards which may follow, and do inestimable harm to the schools 
and nurses of the country. 

May I ask that you send me a telegram on the receipt of 
this letter, assuring me that you arc taking the matter up 
promptly and vigorously? I would also suggest tliat applica- 
tions of desirable nurses should be forwarded, even though 
not meeting our age requirements. 

Yours sincerely, 

(signed) Jane A. Deiano. 

Brief mention of this survey and its results was made by 
Miss Delano in the following linos tukcn from her Annual 
Report: "Through the cooperation and assistance of State 
Boards of Registration, a classified list of all the training 
schools in the country has been secured." 

With the formation of the Emergency Committee on Nursing 
in New York City, a nursing census was planned by it to be 
carried out on national lines according to a method which had 
been developed in a nursing survey of Greater New York by 
Miss Goodrich, a member of the (then) Emergency Commit- 
tee on Nursing, for what was known as *'The Mayor's [Mayor 
Hyhin] (^\»nimittee of Women for National Defense." When 
that committee of nurses evolved into the National Committee 
on Nursing under tlie Council of National Defense, its census 
plan was continued on a national scale during the summer of 
11*17. TIjo macJiinery us<'d was tJiat of the ^Vmerican Nuraes' 
Ass()ciation ajid its state brunches. The assoeiutiou made itself 
responsible for collecting the information asked for by Miss 
Nutting's committee and Mias Goodrich, as president of the 



MOBILIZATION 



305 



» 






I 



American Nurses' Association, dii'ectcd the survey and coin- 
muiiicated the results to the respective committees cooperating 
Ib war service.^** 

That census, carried out entirely, as it was, hy unpaid 
volunteers, all of whom were in active nursing work and making 
no claim to Ik? expert statisticians, was a creditable piece of 
work, of substantial practical value. While not a scit'ut ideally 
perfect aur^'ey, it was approximately accurate and sufficed for 
the immediate purpose. In contrast to the first Rtni Cross sur- 
Tcy, which waa a survey of training schools, this one was a 
census of individual nurses. 

The information asked for was: (1) the total number of 
registered nurses; (2) the total niiinl>er of graduate nurses, not 
registered; ('5) numbers of pupils in registered or accredited 
tnining scliools; (3a) in non-accredited training schools; 
(4) the total number of pupiljj graduating in 1918; (5) the 
total number of pupils that could Ix* enrolled in the fall classes; 
(6) the total number of pupils that could be enrolled during 
the year. 

The census figures showed that there were 66,017 registered 
nnrses and 17,758 nurses not registered, making a total of 
83,775 nurses. From the 1570 accredited schools, 13,288 nurses 
had been graduated in 1918, and from the 414 non-accredited 
9ch<x»la, 1099 hud been graduated, uiaktug a total of 14,387 
of the 1918 classes, which brought the total number of grad- 
uate nurses available at the end of 1918 to 98,162. 

Aa to the numbers of student nurses, 38,938 were in accred- 
ited schools, while 3<j33 were in non-uccredited schools, making 
ft total number of 42,571 student nurses in the United States. 
No tigures were obtained from three states where State nurses' 
associations did not exist. The census was completed in 
March, 1018. 

Early in 1918 Congress inquired into tlie nursing reserves 
of the nation: 



Mr. Trammell submitted the following resolution (S. Res. 
185), which was read, considered by unanimous consent and 
agreed to: 

RESOLVED: That the Senate Committee on Military 
Affairs be, and it is hereby, directed to mvestigate and re- 
port to the Senate at the earliest practicable date the avail- 

"See Report of Comniitt«e on Nursing ^Council of NationAl Defense) 
JbIj 29, ]f»n. 



306 HISTORY OF AMERICAN RED CROSS >aJRSING 

able number of trained nursee for service with the United 
States Army ; and whether or not this present available 
nuDdber will be adequate for the needs of the Army wlien 
increased by the anticipated future increments, taking into 
consideration the increased demand when the Army shall 
more largely engage in active conflict; and to inves^tigate 
and report on the advisability of at once establishing train- 
ing sources or schools for nurses for future service with the 
Army Hospitals; and to iuvesticate and report what, if any, 
provisiona have been made to this end by the War Depart- 
ment.'*' 



Ab the summer wore on and the Red Cross continued to draw 
nurses from institutional fields for the Military Establishment, 
Miss Noyes was confronted by the imminent p<:iS8ibility of 
breaking down completely the efficiency of the nursing sys- 
tems in iilrcMidy overcrowded civilian hospitals. General Oorgas 
in August, liU8, was calling for one thousand nurses a week. 
The civilian population constituted, however, the second line of 
defense. Their health might Ix* seriously undermined by this 
exhaustive drain upon the supply of physicians and nurses. 
**We have only one graduate nurse left," wrote superintendents 
of smaller schools of nursing to Miss Noyes, "and if you call 
her into service, we shall be forced to close our doors." Some 
institutions had already done so. 

To secure scientifically accurate data by which the Nursing 
Sen'iee might b<» guided in its withdrawal of nurses from civil 
establishments, Miss Delano and Alisa Noyes sug^sted early 
in the summer of 191S to the War Department and to offi- 
cials at National Headquarters that the Ued Cross make a 
complete survey of the nursing resources of the nation. On 
August 27, 1018, the Surgeon General wrote to Mr. Davison, 
chairman of the AVar Coimeil : 

Because of the increased militnry programs it is necessary 
that there should bo immodiatoly available definite informa- 
tion as to the number of graduate nurses available for mili- 
tary service; also supplementary nursing personnel, trained 
hospital attendants, and all others who are qualified to render 
aid under the direction of graduate nurses in the care of 
tlie civilian population. 

As the Red Cross is the agency for recruiting nurses for 
the Army Nurse Corps I wish you would take immediate 
"CoogrcsBionBl Record, January 16. 1918, p. 967. 



I 




MOBILIZATION 



807 



Btepfl to make a nation-wide survey of the nursing resources 
in order that a suffit'ient niimbor of grndunte nurse« may be 
withdrawn for military service with the least interference 
to the possible needs of the civilian population. 

(signed) Wiluam C. Gorgas, 
Surgeon General, U. S. Army." 

mmediate steps were taken for complying with Dr. Gorgas' 
request. The Minutes of the War Council meetings for the 
119th meeting, held September 26, 1918, give a full account 
of what waa done: 

. . . under date of August 29. 1918 (D. R., p. 14G0), the 
chairman had replied to the above letter of the Surgeon 
General of the Army, stating that the Ked Crttss deeply 
appreciated the importance of the work suggested, and that 
the acting general manager had been instructed to set up 
special machinery at Headquarters under expert guidance, 
to manage the survey which will be conducted through Ked 
Cross Chapters. 

The chairman further stated that a comprehensive plan 
had now been submitted (D. R., p. 1538) by the assistant 
general manager for tlic making of suuh a survey; that 

Sucftionnaires had been prepared which would be nejit out 
irough the Chapters, through which very comprehensive 
information on the nursing resources would be made avail- 
able; that, under this plan, an executive manager of the 
nursing survey, Mr. Frederick C. Munroe, had been ap- 
pointed, and a Bpe<.'ial organization had been set up at Na- 
tional Headquarters, at the Divi:«ional Headquarters, and 
thence to every Chapter and branch in the country; that 
the work of canvassing the field to secure facts about every 
nurse would involve a house to house canvas in many parts 
of the country, and hence would require large fort-es of 
workers; that if all the facts that can be useful are to be 
gathered from this survey, the tabulation work would be 
very great; that the number of questionnairetv that would be 
sent to National Hertdqunrters to be classified and analyzed 
is estimated roughly at 300.000; that tabulation nf this 
zreat number of questionnaires can be done only by methan- 
iral mean-s and that plans were now being completed to use 
the so-calleil "Hollerith System," which would involve ma- 
chines, punches, special cards, filing oases, and a force of 
fifty or sixty clerks for about two montlis. 

"X>ocuineDU of Record, pp. 1408-60. 



308 HISTORY OF AMERICAN RED CROSS NITISING 



He further stated tliat a request for an appropriation of 
$6n.()f)n had now been received from the director of the 
I)epiartment of Nursing, approved by the assistant general 
manager, to cover the cost of making this survey, including 
the printing and distributing of questionnaires. Headquar- 
ters* expense for machines, punches, cards, filing cases, and 
clerical hire, and Division expenses for clerks, traveling and 
publicity. [The appropriation was granted."] 

The statistical division was under the direction of Mr. C. S, 
Quinn. 

In a letter sent to all the Division directors^ Miss Delano 
aaid in part: 

The survey is quite apart from the enrollment of Red 
Cross nurses and will be conducted more nearly like a census 
than an enrollment, and for this reason it will be necessary 
to secure the assistance of people who have had experience 
in conducting surveys and compiling statistics. Mr. Munroe, 
of Boston, who is an expert along these lines, has been placed 
in charge of the work at Red Cross Headquarters. I have 
already appealed to the State nurses* associations, who 
made the former survey, urging their cooperation and we 
are advising with the Committees Ofi yurnng of the Ameri- 
can Red Cross and tlie Cov^ndl of Naiionnl Defense and the 
Surgeon GeneraVs office. . . . 

We are anxious to secure definite information concerning 
all the nursing resources of the community, including not 
only graduate nurses, registered and unregistered, but pupil 
nurse**, practical nurses, trained attendants, raidwives, etc 
This places the whole work on a different basis from any 
previous suney and will make available the information so 
greatly needed at this time in meet military necessities and 
protect the welfare of the fommunities. 

Definite plans outlining the work will be issued as soon as 
possible. 

The coming of tlie Armistice with its welcome relief from 
high tension had an inhibiting effect on the processes of the 
survey and when, in the spring of 1010 the Bureau of Nurs- 
ing Survey reported that field activities were drawing to a 
close, it had received but 57.0% of the expected returns. The 
questionnaires filled out in sufficiently complete form to be 

■Sc« Minut«fl of the 119tli Meeting of the War Council, September 26, 
1018, pp. 1556.1957. 




MOBILIZATION 309 

utilized showed 155,918 women broadly classed as nurses, and 
coming under all the various headings indicated in the letter 
quoted above, from Miss Delano to the Division directors. 
From the averages it was computed that the whole number 
of nurses of all grades, in the country, would be about 269,288, 
but the minute classifications could not be pushed to a con- 
clusion, nor was the final completion of the survey as a whole 
poesible, after the return of peace. 



CHAPTER VI 



RELATION OF THE NVRSINO BEKVICE TO THE AB] 



Organizaiion of Uniis — Base Hoapiials — Hospital Units — 
Emergency Deiachments — Training School Units — Special 
Units — Cantonment Zone Service — Mexican Border Service 
— Equipment and Insignia, 

POPULAR opinion bns made af the American Red Cross 
nurse a romantic embodiment of personal beauty, of 
steadfast courage and sympathy, of womanly sweet- 
ness and geiitle strength. It has, moreover, pictured her at 
the forefront of war, set high above the ugliness and stench of 
combat, unperturbed, serene and holy by reason of this beauty 
of person and character, a shining ideal toward which the dy- 
ing soldier tunied his glazing eyes. 

Among the eighteen thousand American Red Cross nurses 
who served with the iVmerican Armies during the European 
War, sentimentalists could have found senrcely a single woman 
who fulfilled in outward appearance at least this radiant con- 
ception of the angel of the battlefields. Instead of the flowing 
white veil and the imaiaeulate uniform of popular fancy and 
pistered fame, the Red Cross nurse wore the utilitarian cap of 
the graduate nurse and the practical gray uniform of the field; 
sometimes she was muffled up in slicker, with storm boots on 
her f(H't and 8ou*westrr pulled down over her eyes; or again 
she had drawn a sagging, weather-l)eaten sweater about her 
shivering body. Instead of a seraphic-faeed girl, she was far 
more frequently a woman of mature years, long familiar with 
the seamy side of human relationships, long acquainted with 
the sadness bom of working day and night with the two supreme 
realities of human existence, Life and Death. She had little 
opportunity for gentle speech to the wounded in moments of 
stress, only time and strength to utter brief words of instruc- 
tion to corpsmen and stretcher-bearers who assisted her. Highly- 
trained instrument in the care of the sick that she herself 

810 




RELATIOiN OF NURSING SERVICE TO THE ARMY 311 




was, she could manifest uo reactions of her own personality or 
of her own emotions. Though her throat might ache with sym- 
pathy, her mind must be alert, her eyes must be clear, her hands 
steady for the performance of her manifold duties. 

As the personality of the individual woman was lost in the 
efficiency of the expert nurse, so was the identity of the Ameri- 
can Red Cross Nursing Service lost in that of the Army Nurse 
C-orps. So close was its relationship, so wlKtle-hearted was its 
WKijjeration with the United States War Department that its 
nurses, during the last months of the duration of hostilities, 
clurrfully laid aside the Red CVoss, that B;vmbol of humani- 
tarianism which had led them to pledge loyalty and service to 
an ideal of patriotic altruism, that they might conform in all 
particulars to the regulations of the Military Establisliment. 

How the individualistic humanitarian instincts of the relief 
worker during the Civil and Spanish-American- Wars crystal- 
ized into tlie Red Cross ideal, how the affiliation of tlie Ameri- 
can nursing profession brought this shadowy vision of the care 
of the sick and wounded of armies in war from the realm of 
vague aspiration into that of deiinite actuality, how this germ- 
idea developed into the official reserve of the United States 
Army and Navy Nurse Corps, has already been shown. Into 
this complex pattern of American war nursing, the lives and 
atXHmiplishmeuts of many women have been woven. Among 
the seven who in turn have stood at the head of the Govern- 
ment's nursing forces, — Dorothea Dix, Anita Nowcomb Mo- 
Gee, Dita Kinney, Jane Delano, Isabel ^[clsaae, Dora E. 
Thompson, and Julia C. Stirason — the World War brought into 
sharp relief the last two as superintendents of the Army Nurse 
Corps. 

By training and temperament, these women were both 
iquely fitted for the work each accomplished in the Army 
urse Corps. Miss Thompson was a veteran member of this 
organization. After post-graduate work in operating-room 
methods at her alma mater, the City Hospital, Blackwell's Is- 
land, New York City, she did private duty nursing for four 
years in New York City. She was enrolled as a nurse April 
22, 1002, in the then infant Army Nurse Corps and was ap- 
pointed as a chief nurse in August, 1905. Service followed at 
tterman Oeneral Hospital, where her work as chief nurse 
ring and after the San Francisco earthquake was highly 
tonuncudcd. Later, she was sent to Manila to serve as chief 



312 HISTORY OF AMERICAN RED CROSS NURSING 



nurse of the Division Hospital. In May, un4, she became 
a member of the American lied Cross ^Nursing Service. Dur- 
ing tlio same year, she was ap|)oiuted Superintendent of the 
Army Nurse Corps, following t!ie death of Miss Mt'lsaac. In 
this capacity, she served until December 30, 1910, when she 
tendered her resignation. She then took extended leave of 
absence, at the expiration of which she was appointed as- 
sistant Superintendent of the Army Nurse Corps and at her 
own request was assigned to duty in the Philippines. 

Pa i nstak i ngly f a i th f u 1 to mi nutiae, M iss T hompson poa- 
Bessed that type of mind often described as the first pro- 
requisite to genius. Hera was an infinite capacity for detail, 
which made her invaluable in the performance of her sharply 
defined duties in the Surgeon Generars office. Iron-clad regu- 
lations handed down by the high officials of the War and 
State Departments controlled to the last detail the complicated 
process by which an American Ked Cross nurse was assigned 
to active Army service. Miss Thompson piloted the Army 
Nurse Corps through tliese narrow channels with a faithfulness 
characteristic of the *'Army mind." Beneath a certain cold 
reserve of manner born of her exacting tasks, she possessed gen- 
tleness and sweet restraint. She was absolutely free from what 
may be termed the politician's instinct. 

The mcteor-Iike ascendency of Julia Catherine Stimson of- 
fered sharp contrast to the unobtrusive rise of her predecessor. 
In the blinding light of war, her dominant personality stood 
out in the same bold outlines as did her Amazonian physique. 
Her regular, boyish features habitually wore a thoughtful ex- 
pression, which brought to the observer an impression of dig- 
nity and power. Her well-trained mental processes, clean-cut 
often to tbe point of brns<iuc speech, were as direct in their 
focus as were her keen blue eyes. 

The daughter of a New York clerg;>Tnan, Miss Stimson was 
graduated from Vassar College and from the School of Nurs- 
ing of the New York Hospital, New York City. For three 
years she was superintendent of nurses at the Harlem Hos- 
pital. She went to St. Ix>ui8 in October, lt>ll, to do social 
service work in Washington University and in the St Louis 
Children's Hospitals, and later becami' superintendent of 
nurses of the Washington University Training School for 
Nurses. She volunteered in 1009 for patriotic service under 
the Red CroBs, when enrollment of nurses was being under* 



RELATION OF NURSING SERVICE TO THE ARMY 313 



I 

¥i 
■ ^ 



^takcn through Rod Cross Chapters. Her first opportunity for 
*ftctive duly under the lied Cross flag came iu 1U13 during the 
Ohio flood. 

When the Red Cross Department of Military Relief author- 
ized the organisation of Base Hospital No. 21, within the 
Washington University Medical School, Julia Stimson was ap- 
pointe<l diief nurse. She served with dial inot ion iluring its 
subdcquent assignment to the British Expeditionary Forces. 
Her successful work in the Washington University School of 
Nursing, as well as t.he fact that she was an alumna of Vassar, 
caused her name to he brought forward during the spring of 
1918 as a natural selection for the head of the preparatory 
course of the Vassar training school project. The Chief 
Snrgeon, American Expeditionary Forces, however, assigned 
Miss Stimson in April, 1018, tq the ofiice of the American 
R^d Cross in Paris at the request of the Red Cross rt)mini8- 
sioner t*:) serve as (^hief Nurse of the American Red Cross in 
France. On November 1.5 of the same year, General Ireland, 
who throughout his service as Chief Surgeon of the American 
Foroea in Franco and later as Surgeon General, United States 
Army, had been a stanch friend of the Red Cross Nursing 
-Service, appointed Miss Stimson Director of the Nursing Ser- 
ice of the American Expeditionary Forces. In July, 1919, 
Stimson returned to the United States to succeed Alisa 
Goodrich as Dean of the Array School of Nursing. Secro- 
ttry of War Baker appointed her Superintendent of the Army 
Nurse Corps tive months later. 

The special relationship between the Army Nurse Corps and 
the American Red Cross Nursing Service was defined in b 
paragraph draftefl by Miss Delano wlien she was superintend- 
ent of the Army Nurse Corps and was printed in the (191 ft) 
Manual of the Medical Department, United States Army. The 
paragraDh follows: 

102. The enrolled nurses of the American National Red 

Cross Nursing Service will conatitutc the reserve of the Army 
Nurse Corps, and in time of war or other emergency may 
with their own consent be assigned to active duty in the 
Military KstabliKlunent. When the eincrgeiicy necessitating 
the employment of reserve nurses is imminent, the Surgeon 
General will request the proper officer of the Hed Cross 
Society to nominate from among the enrolled nurses qiialitied 
for the work to be done as many as the Surgeon General 



3U HISTORY OF AMERICAN RED CROSS NURSING 

may deem necessary to enable him to choofie thofie for as- 
eignment to active duty, 

(a) When called into active ecrvice they will be subject 
to all the established rules and regulutions for the govern- 
ment of the Nurse Corps, and will receive the pay and 
allowance of nurses on the regulnr list. 

(b) A reserve nurse will not be reheved from active serv- 
ice ejccept by order of the Surgeon General. Except in case 
of misconduct she will, if she so desires, be furni^:hod travel 
orders to her home before the order of relief shall take 
effect. . . . 

(c) When a reserve nurse is assigned to active service the 
Surgeon General will by letter promptly advise the proper 
officer of tlio Ked Cross Society to thnt effect. When she is 
relieved from active service he will communicate that fact 
likewise by letter, stating the cause of her relief and whether 
her services have been satisfactory.^ 

On Dccorabcr 18, 1016,^ Secretary Baker issued Regulations 
Governing the Employment of the iVmerican Red Cross iu 
Time of War, which contained the following paragraph: 
"10. The Red Cross units organized for service with the Army 
or for the purpose of training personnel therefor are: 1, am- 
bulance companies; 2, base hospitals; 3, hospital units; 4, sur- 
gical sections; 5, emergency nurse detachments; G, sanitary 
training detachments; 7, information service; 8, refreahment 
units and detachments; 9, supply depots: 10, general hospi- 
tals; 11, convalescent homes," 

Eflicient and friendly cooperation of the closest type existed 
during the European War between the Army Nurse Corps and 
the American Red Cross Nursing Service. By letter, by tele- 
phone, by special messenger, Miss Thompson and Miss Delano 
and Miss Noyea kept iu touch with each other. Calls went 
from the Surgeon General's office, first hx'ated in the Mills 
Building and later moved to temporary offices flanking tho 
Botanical Gardens at Eighth and B Streets, to National Red 

'Munual for the Medical Department. U. S. A., 1916, p. 47. 

•These RegtiUtinnd of DiH-ember IS. 1016. were hiter replaced by SperiAl 
ReKuliitionH, Nn. 61. War Dc|nirlmiMit, Oclober 8. 1017, which Re^lutinns 
"includo and ari' identical with the HeguIation» Governiii|( the Kiiiploy- 
menl of the American Ueil Croga in Time of War (December 18, 1016) 
and Oenerul <>rder» No. 82, War Deiiurtment, lftl7." Spwial Re^lationa 
No. (Jl furiued the ullkiiil guide-bcKik of the American Red Cross during 
the remaindiT of the participation hy the United States in the European 
War. 



RELATION OF NURSING SERVICE TO THE ARMY 315 



'Cross Ileadquarters ; Miss Noyes in turn sped these demands 

Division officios and Local CommittecB; while the Red Cross 
publicity organization spread tlie appeals broadcast over the 
length and breadth of the laud, until on November 11, 1D18, 
the United States Army Nurse Corps totaled the largest body 
of professional women ever mobilized for patriotic service. 

Far removed, however, from its final war strength of 21,- 

t80 members was the Army Nurse Corps on April 6, 1017. 

ly 2ii5 regular and 1G5 reserve members constituted the 

Oovemment's nursing forces when the United States declared 

war. 

Military science decreed that the sanitary personnel within 
the armies of civilized countries should constitute ten per cent 
of the strength of the forces. Secretary IJakcr contirmed this 
opinion by his orders of June, 1917. The General Staif, Ameri- 
m Expeditionary Forces, fiually agreed that the total sani- 

■y personnel, othcers, nurses and enlisted men, should be 

seven and sixty-five hundredths per cent (7.05% ), The Chief 

Surgeon in a letter submitted August 11, 1917, to the Chief 

of Staff stated that for an army of one null ion men, 22,430 

airses would be required. He added that "it is believed that 

this calculation is erroneous, the error will be on the side 
of conservatism." ^ 

The Army estimated that the ratio of one uurse to every 
ten hospital beds was a safe one. In a memorandum prepared 
in February, lOlS, by tlie Surgeon GeneraFs office for Secre- 
tary Baker, the following statement was made: 

The ten-bed-to-one-nurse ratio is admittedly a restricted 
allowance, offering scant margin of safety to take up a serious 
epidemic. As t^hown on the tabular sheet, the present actual 
ratio in the United States is one nurse to 15.8 beds. To 
meet an epidemic emergency, additional nurses must be re- 
quested after the need has appeared, making at least tem- 
porary inadequacy inevitable.* 

The assignment to active duty of fifty base hospitals organ- 
ized b^' the Red Cross in 1016 and 1D17 for the Army formed 
the skeleton of the hospitalization of the United States Medi- 
cal Department in France. When these massive columns were 

•••nUtory of Nursing Adivitien^ A.K.F., on the Western P'ront during the 
War PtTJod," J, 0. SlinifMin, p. 7, Surgeon Gcnerttrs offit'c. Wash., D. C. 
*Sec Mler wrilUfn by Jane A. Dclnnu »n February 15. 1918, to 
'aJ W'iUiam C. Oorgaii; Bed Crons Archives, Wash., O.'C- 



316 HISTORY OF AMEKICAV RED CROSS NURSING 



ordered overseas during the Biunmcr of 1917 and to the can- 
tonments of the National Army, Surgeon General Gorgas au- 
thorized the organization of fifty additional one-s, beginning 
with Nnniber Fiftv-fonr. Tht^e baw hospital units were to 
be organized on a basis of tivr hundred In-ds, witli n nnrsing 
personnel of sixty-live members. The Surgeon General's offiee 
stated that they did not believe that these units would be or- 
dered into the field, however, until after the original fifty base 
hospital units whieh the Red Cross had organized and 
equipped had been called into active service.* 

The first branches of the iVmerican Army to see foreign 
BervicD were six base hospital units which were assigned to 
duty with the British Expeditionary Forces several weeks 
after the United States declared war. Upon arrival in France, 
these units were placed in charge of six British general hos- 
pitals, of from fifteen hundred to twenty-five hundred bed 
capacity, which were located in the Rouen and Le Treport 
areas. The original nursing staff of sixty-fivo members was 
found to be inadequate, so the Surgeon General's office called 
for additional nurses in sufheient numbers to raise the staffs 
to one hundred nurses each. Nurses from Red Cross hospi- 
tal units were used for this purpose and "casuals" were also 
sent over. The organization of alt fuliiro Imso hospital units 
was undertaken on a basis of one hundred nurses rather than 
sixty-five. 

On February 21, 1918, Miss Thompson wrote Miss Delano 
of the first change in m(»thr»d of assignment nf reserve nurses 
to active service from the former system of unit organization. 
The Surgeon General's office suggested that, in the future, 
the nurses who were enrolled by the lied Cross should not be 
assigned to specific base hospital unitii, as had l>een done with 
the first fifty, but that they shouhl Ih' held as a general nursing 
reserve, to be called upon as available and as needed. "The 
advantage of this procedure," wrote Colonel Winford Smith, 
then in charge of the Base Hospital Division of the Surgeon 
General's office, "would be that it would not be necessary to 
keep track of specific groups which might have to be with- 
drawn from service at some place to go with the base ho»-] 
pital to which they had been assigned, nor would it be uoce»-| 
sary to hold nurses on the inactive list becatise of ihei 

•5?o« letter written by Dor» E. Tbompeon to Clani D. Noyc», October 
8, 1D17. 



RELATION OF NURSING SERVICE TO THE ARMY 317 



lipnmpnt to base hospitals not yet in service. If the mirscs 
itt^ eiin)lled in a general reserve, they can I>e eaUed as needed 
and afifiipned where they are needed most.'* * Under this plan, 
the iSurgeou General's offiec hoped to develop a reserve supply 
in the cantonment hospitals, from which nurses would be drawn 
whon a base hospital was to be organized for service in Great 
Britain or Frauee. 

The method by whi<?h the Surgr/on General's ofTu^e advised 
the Nursing Service of the net^ds of the Army is well illus- 
trHt4*d in two nxjui^ts for nurses which were received in the 
late winter and early spring of 1!>18. Ou February 28, 1018, 
t^olonel Smith wrote Miss Delano that the Surgt^on General 
would r€M]uire approximntely tivc thousand nurses between 
March and June, in addition to those already assigned to base 
hospital units. Miss Thompson partially echoed this request 
in fl letter written to Miss Noycs on March 4, in which she 
asked that the Ked Cross "nominate as soon as possible 450 
nurses needed for immediate assignment, in addition to the one 
hundred nurses" a month w*hich the lied Cross was mobilizing 
during January, February and March for immediate assign- 
ment to the American Expeditionary Forces. 

Ihiring the middle of December, 1917, Miss Noyes had ex- 
perienced difficulty in convincing nurses that the time had 
arrived for them to relinquish their civilian affiliations and to 
undertake active military service. The Ked Cross enrollmentj 
then of eight thousand nurses pledged to active service upwn 
rail, was at this time wholly uiu-lassitied. Two methods of 
utilizing thia nursing reserve cxmfronted Miss Noyea; on the 
one band she miglit weed out from the giMienil files of the Nurs- 
ing Sen'ice by detailed and tedious corrcHpouileiict! tlu* names 
of all women who met the citizenship and physical require- 
TDcnts of the Surgeon Gcnerfll's office and who were, more- 
o\-fr, willing to respond to an immediate call; on the other 
hand she might present the military need to the nursing pro- 
fession by speaking personally to large groups of nurses in all 
pATtB of the conntry. She finally decided to take a speaking 
trip during December, 1917, and January, lf)18, through the 
principal cities of tijo United States to address mass meetings 
of nurses. She returned to Headquarters during the middle 
of February', 1918. 

*8«e lett«r written by Dora K. Thompson to Jane A. Delano, February 
21. 1918. 



318 HISTORY OF AMERICAN RED CROSS MUSING 



Hardly Lad she bcguu when she found out the reasons why 
nurses were slow to, volunteer for the additional base hospitals 
and the groups of *V'asual8'* for which the War Department 
was then pressing the Kcd Cross. To her appeals for nurses 
for cantonment hospitals in this country, members of her 
audiences responded with the statement that three thousand 
nurses were known to be listed u{K)n the muster-rolls of the 
fifty base hospitals then awaitinj^ assipiment to active duty, 
and that several hundreds of these very women had been mark- 
ing time for weeks at the port of embarkation, Ellis Island. 
Their transportation was delayed on account of orders to hold 
all non-combatants and to rush the (Himbatants overseas, but 
this information, of course, was Tiot given out to the public 
for obvious reasons; nor was it kuuwn in the Surge4)n General's 
office when the nurses would be sent overseas. Notification 
as to accommodations on the transports was often sent but a 
few hours before sailing. As long as the services of these 
women remained unutilized, argued Miss Noyes' listeners, the 
demands of the cantQnmenta could not be so urgent. Direct 
foreign assignment, moreover, appeared far more picturesque^ 
more desirable. On the other lumd, the Surgeon GeneraFs 
office held to the policy tliat the nursing statTs of base hospitals 
should not be scattered among the cantonments at this time, 
as the sailing of tlieir units was imiuinent and it was thought 
that their assignment and almost immediate withdrawal would 
add to the already heavy burden at the camps. Miss Thomp- 
son and Colonel Smith, naturally, knew that an initial experi- 
ence in military routine in the cantonment hospitals for nurses 
as well as for officers and enlisted men would heighten their 
efficiency, so in order to correct the general mi.sunderstandiug 
that the Red Cross was in no great need for nurses for the 
Army, the nurses of the various units were finally sent to the 
cantonments and Army general hospitals throughout the coun- 
try for duty pending the sailing of their units. Miss Thomp- 
son wrote Miss Delano on March 8, lltlS: *'In order tn meet 
the need for nurses in this country, the entire group of nurses 
attached to base hospitals not yet ordered out, will lie ordered 
into service upon receipt of their names in this office. It is 
.thought advisable, however, that no more than ten (10) nurses 
from any one bas*^ hospital be ordered to any one cantonment 
hospital, lest we cripple tbc hospital when the nurses must be 
withdrawn," 




RELATION OF NURSING SERVICE TO THE ARMY 319 

By the late spring of 191S, tlie Siirgeon General's office had 
estimated the number of nurses which the Army would require 
of the Red Cross reserve. In a letter written March 8, Colonel 
Smith stated that **the number of nurses estimated for our re- 
quirements up to January, 1919, including those now in ser* 
vice and the 5000 askwl for by June 1, is 25,000." Early in 
the summer of 1918, this number was greatly increased. On 
July 27, Brigadier General Robert E< Noble advised the Di- 
rector General of Military Relief that at least 2500 additional 
nurses would be needed between that date and September 16. 
On August 1, 1918, Surgeon General Gorgas issued to the Red 
Crosg his historic appeal : 

I call upon your organization, as the chief nurse recruit- 
ing agency of the Army, to employ every possililfi means tn 
increase tlie enrollment of nurses for immediate assignment 
to duty. 

With the contemplated increase in the Army both at home 
and overseas, tl»ere mus-t be a proportionate inrrease in the 
number of nurses in the service. The Army today is grow- 
ing faster than the Nurse Corps is increasing, and as the 
Armies overseas enter the front line trenches in creator num- 
bers, the greater will be the need for nurses in the Army 
Nurse Corps. 

I, tlierefore, urge upon tlie American Red Cross, through 
its Bgeueiea, to bring to the attention of the trained nurses 
of the co!mtr>'. the necessity of immediate offer of service, 
and then enrollment in the Army Nurse Corps. 

1 hesitate to deal in concrete numbers, but 1 desire to 
emphasize the fact that I need today a very material in- 
crease in the Army Nurse Corps, and desire this increase 
in the ratio of at least a thousand a week for the next two 
months. 



These requests, together with the assistance which the Amer- 
ican Red Cross was giving the Women's Committee of the 
Council of National Defense in recniiting student nurses for 
the Army School of Nursing and for civilian hospital Bchools,'' 

'See letter written July 8. 1918. by the actinj; pencral manaf^r 
Xattona.1 Red CrosH HeadquHrterB, to ttie Division iiiatiafceru regarding a 
plan to ftg^ist the Women's Committee of tlio Council of National Defense 
to rwniit student nurHen for the Army School of Nursing and civilian 
koffpital fiohoola of nursinjr. See also letter written by Jane A. Delano to 
tDiTiAion DirtTtors of Ntirttin^. attaolicd to and (rannmittcd by the above. 
Steo also nuggeateil letter tn ChapterR attached to and transmitted by tlxe 
above letter of the acting general manager. 



320 HISTORY OF AMERICAN RED CROSS NURSING 



brought, by July, 1919, the total uecda of the Army to fiity 
thousand graduate and student nurses. Fifty thousand grad- 
uate and student nurses! This was the resjMjnsibility which 
fell to Miss Dehmo, more than to any other woman. As chair- 
man of the National Committee, the American Red Cross and 
the Anierienn nursing profe-saion had entrusted to her vision 
the development of Red Cross nursing ser\'iee, if now^ at the 
supreme umment, this organization whieh her hrain and hand 
had ereated nnd nurtured, failed to meet the obligations which 
war laid upon it, to her more than to any other woman would 
belong the ovom'helming catastrophe and despair of its failure ; 
and in crowded wards of base hospitiils uud evacuation sta- 
tions, American men would have to endure the agony of modem 
battle casualties, unalleviated by adequate nursing care. 

A definite problem of supply and demand confronted the 
Red Cross, On one side of tlie etjuatiou were the nursing re- 
sources of the country, distributed in the fields of private duty 
nursing, in institutional work, in public health nursing and in 
the advanced classes of schools of nursing. On the other side 
were the needs of the Military Establishment The responsi- 
bility of the Red Cross was to select from these; fields nurses 
sufficient in number to meet war needs, yet to withdraw them 
in such a way that the health of the civilian population would 
not be jeopardized. 

According to the Regulations Governing the Employment of 
the American Red Cross in Time of War, which Secretary 
Baker issued on December 18, 1910, the four types of unit 
through which the Army secured nurses from the Red Cross 
were base hospitals, hospital units, surgical sections and emer- 
gtmcy nurse detachment. 

After steps had been initiated to meet the general demands, 
groups of nurses expert in the care of special diseases were or- 
ganized by the Nursing Service for duty in four special hos- 
pitals of the Me<lical Corps, the Orthopedic; the Fracture; the 
Eye, Ear and Throat; and the Psychiatric Hospitals. Public 
health nurses also were ejiUed for by the U. S. Public Health 
Service for duty in extra-cnntonment zones. 

Paper charts and pamphlets outlining the requirements, pur- 
pose and probable future s<*rvice of each type of unit were sent 
out to Local Committees on Red Cross Nursing Service and 
to civilian hospitals from National Headquarters, and later 
to the same Local Committees from Division offices. With 



RELATION OF NURSING SERMCE TO THE ARMY 321 



I 
I 

I 



I 



ttnremiuing energy, the field workers set out to fill ihc itnits. 
Individual nurses were approached with the suggestion tliat 
ibey undertake military- senioe in some oue of these units. If 
they met the requirements of the Army, they were rnrollod 
in the Red Cross Nursing Service and their ninnes ehivke<i off 
against given positions in the organization eharts of the nntts. 
When one of these struetures was entirely e>»nipleti', its iiinnter- 
in-roll or personnel-list was sent to the War Department. Tho 
Surgeon General then ordered the nurses into active servieo; 
travel orders were issued to eaeh nurse. The procedure by 
which the majority of nurses serving in the Europ<Min War 
were mustered into military duty is well illustrated by the de- 
tailed steps taken in the c^se of a member of an eniorgency 
detachment 

"Mary Brown," a nurse engaged in private duty nursing at 
Cascade, Iowa, desired military service. She had previously 
learned that the Ked Cross Nursing Service was the reserve of 
the Army Nurse Corps, so she wrote tx) the nearest lx>cal (Vim- 
mittee on Red Cross Nursing Service. Tlie <*iuiirriiun of this 
Local Committee opened corresjwndence with Mary Brown, 
or In a personal interview, required by the National ( •oinmit- 
tee if possible, gave her the necessary applicution piip4_;rs, told 
her that an emergency detachment was then under proivsa of 
organization in her locality and advised her to join it Mary 
Brown expressed her willingness, filled out her application 
papers and in due time underwent a complete physical exam- 
ination and immunization for typhoid nnd pHnityplioid, ('iliis 
inoculation was later given at cantonment hoHpitals.) The 
chairman of the Ix)cal Committer in the city near Cnscatle 
entered Mary Brown's name on the lists of one of tho emer- 
gency detnchmont^ for which the ci>inmitU*e was re-S]Vinsible, 
secured her training ^-hool credentials, her certilieatps of exam- 
ination and intx'ulatzon, her latest address and her dttXe of 
aTailability and sent them all to the director of the Depart- 
ment of Nursing, Central Division, who passed iipf>n them 
and forwarded them to National IliL^adquarters. Miss Noyea 
then wired Uary Brown and in a telegraphed answer n^eived 
con£nnation of the statement in her enrollment papers that 
she would be available for assignment on Jnne 5 at Cftscadei 
Iowa. Mim Nojea then sent this last yellow telegram, tn^ethflr 
with the other papen^ to Mba Tbompaon. The 8ar]geo& Oco* 
erml's order followed within a few days: 



822 HISTORY OF AMERICAN RED CROSS NURSING 

Mary Brown, Reserve Nurse, Array Nurse Corps, now at 
Cascade, Iowa, will proceed without delay not later than 
June (>, after having taken the oath of office, to Camp Dodge, 
Des Moines, Iowa, and will report to the Commanding 
Oftioer, United States Army Baae Hospital, for assignment 
to duty. 

Travel is necessary in the Military Establishment." 

This task of locating and stabilizing nurses which devolved 
upon Miss Noyes and licr associates was fraught with tcdioua 
.and troublesome detail. In addition to professional creden- 
tials, izmnunization and physical examination certiEcatioDS, 
it was necessary that the enroHnient papers of every nurse show 
the address at which she might be reached within a certain 
period of time. To this location, within a prescribed number 
of days, the Surgeon General sent instructions, as has been 
shown before, bidding the nurse take oath of oftice and proceed 
to her post of duty. If (ho nurse was not at this given place 
at the time specified in Iut papers, the order for her oath of 
;Office and her transportation had to be revoked and a corrected 
one issued. Nurses often could not understand why travel 
orders could not be forwarded to auotlier town like personal 
mail. The War Department, overburdened with clerical de- 
tail, for its part failed to see in the call for an issuance of new 
orders anything but carelessness and inefficiency on the part 

•In addition to the requtrementB for enrollment in the Red Crow 
Xtiraing Service, the Siir^on Geneml set up the following regulations: 
'*CiUscnB of the United States, native or naturAlized, are uliku liable to 
••errice and no discrinunatiun should be made an far as the mnnner in 
which the citizenship wuh ar<)uirefl ia concerned, if the loyalty and fidelity 
of the individual ia unquestioned. 

In case of medical units ur individuals intended fur service directly 
with or under the forces of nur allies, care shonli) be taken not to assign 
to such units or detail for such scrricc persona who are naturalized dti- 
fjenti of alien enemy origin." 

Married nurses were not eligible for senicc with the Army Nurse Corps. 

Tl»e length of service was covered in the following regulation: **Re- 
•erve nursi^ osHigiied to active aervice during war will bo expected to 
•erve aa long am they may be needed. A nurse who desires relief from 
active aervice may apply therefor by letter to the fiurgeon General, 
through MiH proper eliunnels, stating lier reasons in full. If the reasons 
are sufficient in the judgment of the Surgeon Ueneral her request may be 
granted. Iteturn traiiH|K)rtation will not be authorized to nurses who havo 
sen'cd U'hs than orfe year, unless the need for their serrices ceases to exist, 
or to those who art* disehnrgrd for misconduct. A nurse who is found 
to l»e iinsuitod for the wrvicr pliy«icnlly, professionally or lempcramentwlly, 
will be furnished tran»|Mtrtation to her home for relief from active service, 
without regard to lengtli of service." 




¥ 



RELATION OF NURSING SERVICE TO THE ARMY 323 

of tlie Red Cross in giviug an inaccurate address in the first 
place. Hcn(."e arose the necessity for establishing the rule that 
a confirmation telegram be received from the nurse before her 
papi'rs were sent to the War Depiirtmeut. An idea of the 
oorrettpondence which was carried on taween National Head- 
qnartera, Division offices, State and T>«>cal Conunittoes and in- 
dividuals before a nurse eoiiid be assigned to active service, 
nmy be gained from the following letter written October 12, 
1017, by Miss Noyes to all nurses organizyig units for the 
Army: 

Organizing nurses will please bear in mind the following 
points to make the Service more efficient: 

Fir*t: Do not report to Ked Crojjs Heailquarters a nurse 
as "ready for duty*" before conimuiucatiug with her in order 
to determine this fact. Information upon this point two 
or three weeks old is many times found to be inaccurate. 

Second : Please determine from each nurse her latest ac- 
curate address. 

Third: Communicate with each individual nurse imme- 
diately before sending her name to this office in order to 
make definitely certain her date of availabiUty and her 
accurate address. 

Fourth; Impress upon the nurse that except in case of 
grave illness it is impossible to release her from her promine 
to answer a call when once her name has been sent to the 
War Department. 

Fifth: When a nurse is reported to the Surgeon Gcnerars 
office as "ready/' assignment to duty, oath of office and 
transportation will he forwarded hy that Dcpurtriieut. If, 
by any chance, this is forwarded to an incorrect address, it 
is not only a very serious inconvenience to the War Depart- 
ment to revoke these orders, hut a reflection on the efficiency 
of the Hcfl Cross Nursing Service. 

Sixtli: In all cases when the nurses live in an adjacent 
town, it is advisable to have them assemble at their own 
expense at the larger point where the detachment has been 
organized. In this way. they can proceed together to their 
point of destination. If this is not possible, individual trans- 
portation orders may be issued to each nurse from her own 
home. 

Equipment occupied the last phase of the manifold duties 
derolving upon Miss Noyes and her associates. After Mary 
Brown had served her apprenticeship at Camp Dodge, the long- 




324 HISTORY OF AMERICAN RED CROSS NURSINGi 



coveted orders for foreigu assignment were forwarded her 
through her chief nurse and off she went to Ellis Island with 
instructions to rci>ort as soon as possible to the director of 
Nursing Service, Atlantio Division, American Red Cross, re- 
garding equipuuuit. In New York City, the Bureau of Nurses' 
Etjuipuiout supplied uniforms, blaakets, sou*wester8, boots and 
other comforts to soften the harsh living conditions of these 
nurses of the American Expeditionary Forces. 

The middle span of cantonment 8<»rvice was omitted for the 
memlMM's of the first base hospital units. Their orders read for 
them to proceed direct to the port of embarkation and Europe. 
As was often the case with the soldiers, many nurses waiting 
patiently in cuutomnent wards never received foreigu assign- 
ment. 

These units thnnigh whieh nurses were mobilized by the 
American Red Cross were not only complex in det-ail, but dis- 
similar in purpose. Consequently, each form of organization 
would be treated separately. 

In modern warfare, with its enormous armies in the field, 
its fleets of capital ships at sea and its instruments highly per- 
fected in the science of killing, it is imperative that tlie Army 
and Navy be supplemented by organized volunteer aid. Sir 
Frederick Treves summarized this need: 

In time of peace, no army medical service can be main- 
tained on a war footing. There is involved at such times 
an elaborate scheme for exjjansion in war; but one promi- 
nent and inevitable feature of that scheme is the enrollment 
of a vast body of doctors, nurses, orderlies, motor drivers, 
clerks, cooks, dispen>;erM and the like. In puch a work, a 
civilian society can act with ^eater ease and promptness 
than can a huge organization like the War Oilice. and thus 
it is that in the supply of personnel, the Red Cross societies 
have undoubtedly rendered sterling service.* 

In the Rod Cross Annual Rejiort for l'.»16,*o Colonel Kean 
outlined the zones into which the military service for the rescue 
of the wounded of armies in the field were divided: 

'The hff^ical Record, Vol. 00. page 466. 

'*The Annual Report of the American Nattonal Red CrodS ie published 
yearly in two forms, the flrnt a full report puhlifthed by the chairman 
of the Central Committee, the aecond a somewhat abbreviated report 
puhliHhed aa a Document of Record of the HouHe of Kvprewntatives. Th« 

?uotationH and pufre refercnrea which are lined in this hihtory are taken 
rom tho full Annual Ropnrt piihliiihed by the American Red Croaa, 
tbo av-called "unuOioial report," rather ttiun the CosgrvBaioDal DogoidmiU 



RELATION OF NURSING SERVICE TO THE ARMY 325 

The medical service of the zone of the front is one of first 
airi, tempornry shelter ami transporlation nf the wouDcled 
to the rear. It is manned by trained sanitary soldiers of 
the Army and requires for its servii-e nearly the entire per- 
sonnel of the peace establishment. The Ked Cross units and 
personnel are not admitted to this zone. 

The medical service of the second zone, tlie military base, 
consists of sick transport trains and base hospitals and is 
largely manned by a personnel from civil life, recruitc(i 
either by the Ked Cross or the Medical Department of the 
Army. Its base hospitals are the first trne hospitals en- 
countered by the woujided man in his journey to the rear. 
Here for the first time he finds a good bed with a mattress, 
instead of a cot; trained nurses instead of sanitary soldiers; 
and the highly trained and specialized practitioners from 
civil life. Here he finds quiet and rest and the conditions 
suitable for re<'Overy. 

The third zone, that of the home country, receives the 
overflow and the convalescents from the base hospitals near 
the theater of war. In it the civil hospitals of the country 
are called into use in addition to such general liospitals as 
the medical department may establish. Its medical staff are, 
with the exception of a few trained administrative officers, 
physicians and nurses drav^Ti from civil life. 

Of this structure, the base hospital is the central span 
and the most important contribution which the Ked Cross 
can make for the safety and comfort of the woundud. It 
is immediately and urgently needed as soon as war is de- 
clared, yet because of its numerous personnel and massive 
and costly equipment, it has never heretofore been provided 
in time of peace. Yet so large and complex an organization 
cannot be improvised. Its varied and specialized personnel 
vhen brought together, require time and training to fall 
into orderly adjustment and ellk-ient operation. A chance 
aggregation of doctors and nurses can no more claim at first 
to be an efficient hospital than a thousand men collected from 
the streets can be regarded as an cITcctive regiment. Like- 
wise, its elaborate equipment cannot be purchased in a day, 
or a week, nor yet in a mouth, especially in time of war. 

It has already been shown that by Presidential Proclama- 
tion, dated Auguet 22, 1911, and Act of Congress of AprO 
34, lfll2, the Red Cross ptirsoiiuel constituted in time of war 
a part of the sanitary services of the Government. In con- 
formity with this edict and these statutes, the War Depart- 




826 fflSTORY OF AMERICAN RED CROSS NURSING 



ment, upon the rt'oomrnoiulation of Georfi^e A. Torney, Surgeon 
General of the United StiiU's Army, issued ou September 10, 
1912, Circular No. 8, which contained the following regula- 
tions: 

2. When the War Department desires the use of the serv- 
ices of the Wq(\ Cross in time of war, or when war is im- 
minent, the Secretar}' of War will comniuuicate with the 
president of the society, specifying the character of the serv- 
ices required, and desi^^natin^j tlie place or places where the 
personnel and material will be assembled. 

3. When any member of the Hetl Cross reports for duty 
with the land fonew of the United States pursuant to a 
proper ralL he will therefore he subject to military laws 
and re^rulations as provided in Article Ten of the Interna- 
tional Red Cross Convention of 1906, and will be provided 
with the necessiiry brassard and eertilicate of identity, 

4. Except in cases of great emergency, Red Cross per- 
sonnel serving with the land forces will not be assigned to 
duty at the front, but will be employed in hospitals in the 
home country, at the base of operations, on hospital ships 
and alon^ lines of communicatiuus of the military forces 
in the United States. 

6. Red C'ross organizations will not establish independent 
hospitals or other institutions, but will assist military sani- 
tary formations at the places above indicated. 

6. Before military [)atients are assigned thereto, separate 
establishments maintainetl by the Red Cross Society will be 
placed under the immediate direction of a medical officer 
of the Army. Such officer will i)e held responsible for the 
management, discipline and records of the institution; he 
will regulate admiH^;ions and dis(*hargcs and see that the 
interests of both the Government and the patients are 
conserved. 

7. No columns, sections or individuals of the Red Cross 
Society will l)p accepted for service by the War Department 
unless previously inspected by a medical otlicer of the Army 
and found qualified for the servi<*e expected of them. 

8. The Red Cross Society may be called upon in time of 
war. or when war is pending, for the following columns of 
personnel: (1) physicians and surgeons; (2) dentists; (3) 
pharmatists; (4) nurses; (o) clerks; (fi) cooks; (7) litter 
bearers, drivers and other transport personnel; (8) laborers. 

0. To facilitate the training of Red Cross personnel for 
the dntie^ it may be railed upon to perform in time of war, 
it is divided into tlm^e classes: Class (a) those willhig to 



RELATION OF NURSING SERVICE TO THE ARMY 327 



H The greatest single contribution of the American Red Cross 
™ to the welfare of the sick and wounded American soldier lay 
in its organi7ation and e<]uipmcnt of fifty base hospitals for 
the Unit(*d States Army, The germ idea of a medical unit 
organized from the staff of a large civilian hospital for war 
service in the zone of the base had been conceived in 1914 
by Dr. George W, Crile, of Lakeside Hospital, Cleveland, 
Ohio. The project of organizing such nnits for the Anny was 
brought forward for discussion by Dr. Crile as follows on Oc- 
tober 2r>, 1915, at the sympijsinm on military surgery, Clini- 
cal Congress of Surgeons of North America: 



serve when needed; (b) those willing to serve in home coun- 
try only; (c) those willing to serve at place of residence 
only, etc., etc. 

10. The Red Cross service at the base, along the line of 
communications or in a military <Hstrirt. will be under the 
supervision of a rlireetor general who will c*jnduct tlie serv- 
ice under the direction of the chief surgeon of the iield 
army or ejtpeditiouary force. 

11, For service at the base and along lines of communi- 
cations Red Cross personnel shall be organized into (1) field 
columns; (2) hospital culumns; (3) supply columns; (4) 
information bureau sections, etc., etc. . . . 



Wlien our distinguished American Ambassador, the 
Honorable Myron T. Kcrrick, asked me to take a service in 
the American Ambulance, I suggested that it might be bet- 
ter to form a unit among the men at Lakeside Hospital and 
take complete charge of a given numl»er of patients. This 
proposal was cabled to the American Ambulance and a 
favorable reply returned. This was the beginning of the 
university unit plan of organization for service at tHe 
American Ambulance. 

This plan worked out so excellently in France that it has 
occurred to me that, at least for the base hospitals, it would 
be a workable plan for our Amerir-on Medical Reserve Corps. 
After an informal discussion with the Surgeon Oeueral of 
the Army, he suggested that to stiuuilate further discussion, 
I should outline a plan for a unit to take charge of a five 
hundred bed base hospital. . . . 

These units will he more efficient if they are made up of 
men who have had similar t mining and who know each other 
well, and if they have associated with them a nursing staff 
familiar with their methods. This suggests that the first 



328 HISTORY OF AMERICAN RED CROSS NURSING 

units be made up from the staffs of large well-or^nized 
hospitals, eapeoially teaching hospitals, and that they be dia- 
tributed according to population among the states of the Union. 
In making such un organization of the Medical Reserve 
Corps we must he guided by three fundamental princi])les. 
FirU: each man should he assigned to the fierviec for which he 
is best qualified. Second: the mobilization of the Reserve 
Corps should be countr)'-wide. Third: standard materials 
should be stored so tliat we may not he eaught by a shortage at 
a time when industries are paralyzed. ..." 

A few days previous to this meeting, the Red Cross had 
taken up with Dr. Crile the question of the organization of 
such units. Adelaide Mclvee, chairman of the Cleveland 
Local Committee on Red Cross Nursing Service, wrote on 
October 16, 1015, to Miss Delano that **circular8 and appliea- 
tions have been sent to graduate nurses in this city by Miss 
Allison, the 8uj>eriutendent of nurses of the Lakeside Hos- 
pital, asking them to join an organization composed of a body 
of nurses and doctors for service at home and abroad. This 
circular states that I>r, Crile has been asked by the United 
States Qovenimcnt to organize a society, salary to be the same 
as that of the Red Cross Nursing Service, and that the Gov- 
ernment has promised to equip a hospital of ^ve hundred beds 
for Dr. Crile in case of emergency." 

Mias Boardman telegraphed Dr. Crile on October 18, in- 
fomiing him that according to R(>gulutions issued by the War 
Departmpnt and by Presidential Proclamation, all vnliinteer 
aid must go through the Anioricau Red Cross, and rctpu'sting 
further information regarding his plans. "Great confusion 
now exists,'' she concluded. 

Dr. Crilo in a letter written October 31 explained that in 
view of the uupreparedness in oflFering organized aid to 
wounded soldiers which had been experienced by France and 
England and which many American surgeons had witnessed 
when in foreign service in 1014 and 1915, it was felt that 
**the preparation of our country for offensive and defensive 
maneuvers in time of war should include pre-organized plans 
for medical and surgical service. This is a work," he added, 
"which belongs primarily to the Government With this under- 
standing, at the suggestion of General Gorgas, a tentative plan 
is now iu progress of formation. , . ." 

^Burffvry, Gynrcotogy and Obsiclr%c$^ Januftry, 1016, pp. 68-60. 



RELATION OF NURSING SERVICE TO THE ARMY 329 



In her reply addrosscd to Dr. Criln October 23, Miss Board- 
man cxplHinwi that, bo miieh confusion already existed among 
the nurses that unless it could be cleared up Miss Delano 
might dissolve the Red Cross Nursing Service, in which she 
had enrolled between six and seven thousand of the best trained 
nurses in the country. There could not be two organizations 
undertaking the same enterprise independently of each other 
without leading to great confusion. 

The Regulations of the War Department, Miss Boardman 
■rgued in this letter of October 23, provided that the Red 
Cross should form exactly the same type of unit as that under 
organisation by Dr. Crile. A National Medical Committee 
waa already appointed to take up this work. Dr. Crile's name, 
as well as that of Dr. HarA'cy Cushing, Dr. Lambert and Dr. 
George Brewer, was among the list of members. Should any 
or every hospital in the country that desired to do so under- 
take the organization of hospital units independently of the 
Red Cross, which under its charter was the official volunteer 
agency of the Government for the relief of sick and wounded 
in war, then the Red Cross would go out of existence. 

When in time of war, continued Miss Boardman, the War 
department asked of the Red Cross hospital formations, they 
rere to be turned over to the office of the Surgeon General just 
as it was now proposed to turn over these surgical units. There- 
fore, there appeared to be no valid reason why the organization 
of these units should not be inidertakcn through the medium 
of the Red Cross, in the place of these proposed unite. Miss 
Delano was re^dy to issue regulations that would make the 
nurw's of these unit* able to <^umll as Red Cross nurses, pro- 
vided that they came up to the requirements of the Army Nurse 
Corps and of the Red Cross. 

Eh". Crile replied on Octolw^r 30 to Miss Boardman that "this 
is a matter which pertains to the Medical Reserve Corps of the 
Army, of which I am a meml>er . . ." and that *'I have reread 
with c«re Circular No. 8 of the War Department and find 
nothing therein to indicate any conflict between the Red Cross 
Association and the organization of bospitnl units." He went 
on to say that **the Red Cross may be called upon in time of 
war for certain services at the discretion of the War Depart- 
ment. The Medical Reserve Corps is a part of the Army and 
therefore is, of course, subject to its call." 

On November 2, 1915, Miss Boardman wrote Dr. Crile; 



830 HISTORY OF AMERICAN RED CROSS NURSING 



A number of years ago, the Surgeon GeDeral's office started 
an Army nursing reserve. At first, there were some two 
or three hundred enrolled, but in time the interest died 
out and finally it was reduced to less than twenty nurses who 
reported yearly. In the meantime, the American Red Cross 
had initiated its enrollment of nurses, under Miss Delano's 
remarkably able ejceeutive management. 1 will not go into 
details of development, Imt after three or four years, the 
Army decided to give up its nursing reserve and to take 
the American Red Cross nurses as a reserve. 'I'he plan is 
working very satisfactorily. We have between six and seven 
thousand of the best trained nurses of the profession en- 
rolled; between seven and ei;nht hundred of the most repre- 
sentative nurses in the country are serving as members of 
Loral Committees. We can nnd have mobilized our nurses 
on short notice. We have spent thousands of dollars on this 
work and it would have cost several thousands more, if Miss 
Delano had not given her services without remuneration. I 
have spoken at many nurses' meetings to arouse their in- 
terest. Next year (the work has grown so), we will prob- 
ably give Miss Delano an assistant. She also has an Army 
nurse detailed to her otfice and two or three stenographers 
to assii^t her to maintain this eflicient enrollment. 

Suddenly without any \v((rd to the Hed Cross, various 
doctors are communicated with and the request is made tliat 
they form hospital units and enroll nurses in a reserve corps. 
In several cases our own nurses have been applied to, not 
only to enroll but to secure nurses for this Army nurse 
reserve. Tliis, of course, is leading to great confusion. It 
b breaking up our nursing reserve. The plan of the Sur- 
geon Oeneral's office cannot be kept up except by an or- 
ganization such as the Red Cross, as was evident from past 
experience. 

Miss Delano has already been to New York, has seen the 
superintendents of some of the large hospitals there and a 
plan is being worked out to form units or hospital columns, 
for hospitals of five himdred beds, securing the nurses from 
each hospital for a hospital unit or column. The head of 
such a column would be a member of the Army Medical 
Reserve Corps and the nurses would be from the same hoa- 
pital and those with whom he was accustomed to work. In 
this way, the Red Cross will be able to build up around 
various members of the Med ical Reserve Corps complete 
nospital columns or unitJ*. It is. furthermore, making ar- 
rangements for special instruction for other personnel, such 
as women to run linen rooms and other hospital work and 




RELATION OF NT RSING SERVICE TO THE ARMY 331 

plans to enroll l'uoIcf, etc.^ so as to have a whole unit and a 
complete one. 

Many other points I will not now attempt to discuss. T 
have explained the situation, trusting that the matter cau 
be worked out in fairness to the Eed Cross. 



Miss Boardman and Miss Delano then interviewed the Sur- 
geon General of the Army, only to find that it was the opinion 
of General Gorgas and Major liobert E, Kuble that the or- 
ganization of base hospital units was an undertaking for the 
Medical Reserve Corps rather than for the Red Cross, This 
interview resulted iu the deadlock which Colonel Jefferaou K. 
Ke-au of the United States Army found upon his arrival, Jan- 
uary (5, 1916, at National Headquarters, 

At the request of the Red Cross Executive Committee, Col- 
onel Kean had been detailed by the War Department to act 
as Director General of the newly-created Department of Mili- 
tary Relief of the American Red Cross. A former president 
of the Association of Military Surgeons, Colonel Kean was an 
early and enthusiastic sponsor of the. Medical Reserve Corps. 
He was an alumnus of the University of Virginia. His Army 
record included thirty years' active service at Fort Sill, Fort 
Robinson, St. Augustine, Key West, Fort Warren, Cuba, Wash- 
ington, D. C, and Fort Leavenworth. He had received the 
Campaign Jledal for service in the hidian wars and was chief 
surgeon of an Army Corps during the Hpauish-American War, 
He brought to the Red Cross a thorough-going knowledge of 
Army personnel and methods of procedure, also tact and a 
tremendous faith iu the opportunities for Red Cross service. 
His ability, his lively humor, his keen vision brought him many 
friends, both within the Army and the Red Cross. 

Colonel Kean's first constructive work resulted immediately 
in a more complete understanding of the relation of the Red 
Cross to the Army. On January 24r, 191G, eight days after 
his arrival, he wrote to Colonel Merritte W. Ireland, Medical 
Corps, then stationed at Fort Sam Houston, Texas. Coloijel 
Ireland, like Colonel Kean and Colonel Francis Winter, was 
one of that brilliant group of young officers, since risen to 
meralship in the Medical Corps, who had known and esteemed 
'ias Delano when she had shared with them in IDIO the 
limited deak-space of the Surgeon General's office. In his letter 
lo Colonel Ireland, Colonel Kean stated: 



332 HISTORY OF AMERICAN RED CROSS NLTRSING 



The military preparedness side of Red Cross organization 
has never heen developfd and the consequence is that 1 have 
a new and untilled field in which nothing has yet been done 
except in the two bureaus — the First Aid which [Colonel 
Charles] Lyncli developefl, and Misa Delano's reserve nurijes 
witli which you are entirely familiar. Miss Delano has at 
present botwec»n six niul Keven thousand of tliese and you 
know her well enough to know how well she has them in 
hand. 

The first thing I had to do was with reference to the 
proposed organization by the Surgeon General of surgical 
units. ... I diRcusse<l the matter with the Surgeon General 
and his asstn-iates. I admitted that he had the right to go 
outside of the Red Cross reserve to employ nurses if he 
chose to do so, and that he also had the right to let his 
Reserve Corps ollicera undertake to get up units, altliough 
these would have no oflioial existence. But I pointed out that 
while this was an abstract right, ... it would much dis- 
courage tlje nurses* reserve and the Red Cross would be very 
nearly inhibited from any successful effort to carry out the 
provisions of Circular No. 8, 191:?, in organizing sanitary 
units. I proposed that the units which he had already 
authorized should be enrolled and inspected by me, both as 
a representative of the Red Cross and as his assistant under 
a letter of instructions from him. The three so authorized 
are Crile in'Cleveland, Swan in Rochester, and Cushing in 
Boston. 

My proposition would enable the Surgeon General to make 
use of the assiytauce of the Red Cross, whereas if he re- 
jected it, he would have no place in time of peace to get the 
pecuniary assistance which the Red Cross stood ready to 
offer. Existing orders already provided that when these units 
were called into active service, they came under the orders of 
the War Department, and by placing a regular medical 
orticer in command of each hospital, it became absolutely 
under the control of the Surgeon General. 

On February 7, 1916, Colonel Kean wrote Dr. Crile that 
"with reference to the base hospital which you were authorized 
by the Surgeon General to enroll for service in war, it lias been 
decided after conference between the Surgeon General and the 
National Rtnl Cross that the enrollment will he made through 
the agency of tlie latter, as is omtcmplatcd bv the charter of 
tlie American National Rod Cross and existing War Depart- 
ment orders." 



RELATION OF NURSING SERVICE TO THE ARMY 333 



In a socond letter written February 16 to Colonel Ireland, 
Colonel Kean reported further details of the new project: 

T am starting out now in a few minutes to New York, 
Boston, Rochester and Cleveland, to organize base hospitals. 
We have three already in process of organization in New 
York, one in each of the other cities. There is so much 
enthnginsm abroad that I l>elicve we can organize one in 
connection with every big hospital in the country. My pres- 
ent scheme is to have Hed Cross Chapters accumulate the 
money to buy the equipment for each hospital and store it 
when at hand. It will cost over $*30,000 for each hospital, 
so you see there is nothing small about my scheme ! 

With characteristic briskness and zeal, Colonel Kean and 
iss Delano set about their gigantic task in the early spring 

if 1910. By personal interview or letter, Colonel Kean placed 
bis project before the president of the Board of Directors, or 
the Trustees of each hospital. After they had signified their 
willingness to undertake the organization of a base hospital 
cr>mp«tscd of the personnel within their institution, a director 
*and chief nurse were immediately appointed to undertake 
the enrollment of the other meml>ers of the unit. While these 
busy individuals were interviewing thoir candidates and look- 
ing into past records, Colonel Kean took up with the local Red 
Cross Cliapter the problem of equipment. This meant buying, 
storing and having "ready for instant transportation every- 
thing necessary for the surgical, modical and nursing care of 
five hundred sick and wounded soldiers, from the beds they lie 
upon to every kind of bandage and operating instrument." ** 
rTbis non-perishable equipment, the finest which could be pnr- 

"lascd, was estimated to cost approximately $25,000.00 per 

inJt; this equipment was "found to cost upwards of $75,- 
►0" for each unit before the work was completed." The 
[Comptroller's Kep<5rt for the period July 1, 1017, to February 
ll>10, the months during which the operations of the Ameri- 
Red Cross were directed by the War Council, stated that 
"the Chapters of the Red Cross spent, in round figures, $3,- 
000,000 in equipping base hospitals. In addition, National 

feadqiiarters made a number of appropriations to meet spe- 
cial needs," ^* The equipment of each unit required the use 






u, Fphrimry 7, ini7. Vol. 37, p. 387, 
ixirt. American Rtfd CroAB. 1017. p. 22. 
lurk of Ihv Aiumcan Red CroHS during tho War/ 



41. 



834 HISTORY OF AMERICAN RED CROSS NURSING 



of seven freight cars to transport its beds, bedding, ward furni- 
ture, drugs, dental and surgical instruments, laboratory supplies' 
and equipment, mess gear, sterilizere, ambulances, touring cars, 
motor trucks, motorcycles, complete X-ray plant, kitchen and 
disinfectors. The initial supply of surgical dressings and hos- 
pital garments was at first furnished through committees of 
Women's Auxiliaries of the parent hospital and the coat 
amounted to $8000 for each base hospital imit. After 
National Headquarters had built up its surgical dressings 
department, the Red Cross assumed entire responsibility for 
these articles. 

The relation between the local Red Cross Chapter which 
fumiahed the funds for equipment and the base hospital unit 
was, in Cohmel Kean's words, "that of a big sister, close and 
cordial, but without parental authority." ^° In view of the 
great pecuniary assistance which was expected of the Chap- 
ters, the question of whether they should not have a controlling 
voice in the selection of officers and in other details of organiza- 
tion, had naturally arisen, but National Headquarters had not 
felt it wise to authorize this because the military and profes- 
sional personnel of the units would naturally demand that 
direct control be of a military and professional character, 

A base hospital first included a personnel of 2G5 souls, with 
"such subordinate administrative personnel as may be necea- 
sary" and "such Red Cross volunteers as may be authorized by 
the Director General of Military Relief, upon the approval of 
the Secretary of War." "^ The original number of nurses 
was placed at fifty, but was later increased to sixty-five and then 
to one hundred and llie rest of the personnel raised propor- 
tionately. The personnel of a base hospital as originally au- 
thorized included twenty-three doctors (later raised to fifty); 
fifty nurses (later raised to one hundred) ; twenty-five nurses* 
aides (never called out) ; fifteen reserve nurses (later raised to 
t^^-enty-five) ; and twenty-five reserve nurses* aides (never 
called out) ; and other personnel necessary to care for a fivo- 
hundred-bed hospital (later raised to one thousand beds), 

Tn the Regulations Governing the Employnunt »if the 
American Red Cross in Time of War, authorization f<»r tho 
nursing staff was contained in paragraph twelve, vi^., that "the 

"See AnnuMi Report, American Rod CroAB. 1010. p. 41. 
** Hc'K>iltitii>ii>4 Oowrninf! the Kuiploynient of the Americui Red 
io Time of War, Uei-ttnl*er 18, lOlti. 



RELATION OF NURSING SERVICE TO THE ARMY 335 

organization of a base hospital will l)e . . , fifty nurses, mem- 
bt'Ts of tht' Red ( -rosa Nursing Service, one of whom shall be 
chief nurse and one of whom may be a dietitian. Twenty-five 
Trtjlnnieer nurses' aides." 

To the chief nurse, in consultation with the director of 
each base hospital was delegated the selection of the nurses, 
ihe dietitian and the nurses' aides. All mcmWrs of the nurs- 
ing staff thus selected were required to be enrolled in the Red 
Cro«s Nursing Service. To save unnecessary correspondence 
And to hasten appointments, Red Cross application blanks were 
sent to chief nurses, who secured the training school 
credentials of each nurse not already enrolled. The blanks 
were then sent to the Secretary of the Local Committee 
on Red Cross Nursing Service. The nursing staff consisted 
of one chief nurse; one assistant chief nurse; one night chief 
nurse; one charge nurse, operating-room; five assistant nurses, 
operating-room; one charge nurse or dietitian; '^ one assistant 
nnrse or dietitian; one charge nurse, liuen room; thirty-eight 
nurses for medical and surgical wards; fifteen reserve nurses 
not on the muster-roll. It was suggested that at least three of 
the nurses should have had some practical experience in the 
care of i-ontagious diseases. 

As muster-rolls of the base hospitals lengthened and as the 
Chapters purchased and stored the equipment for each unit, 
the eagerness of laywomen to share in this type of war service 
grew to such dimensions that the Surgean General and the 
Red (Voss decided to include among the personnel of the base 
hospitals twenty-five nurses' aides, with a reserve of the same 
number. This group included for each hospital four diet 
kitchen aides, four aides to be assigned to the linen room, two 
aides to the nurses' quarters and fifteen to the wards. Like 
the nurses, these aides were required to enrol] in the Hed Cross 
and to undergo a thorough physical examination. Their in- 
stnictinn in the care of the sick has already been set forth in 
I preceding section. 

Throughout the strained summer of lfll6 the organization 
of base hospitals proceeded. A vivid picture of Miss Delano 
rcTDaiiUHl in the memory of one of her secretaries at National 
Beadquarters. At the close of an oppressively warm Sunday's 



" Full information ct»ncerning requiremcntft for Bprvico nt« Rod CroM 
diptifUnn may be found in the chapter rt'ldtiog tu the Red Cross Nutri- 
tion Service. 



336 HISTORY OF AMERICAN RED CROSS NIHSING 

work, the chairman of the National Committoo was on her 
knees on the floor sorting out nurses' papers. Her secretary 
reached over to a file-tnse and the string of beads which she 
■wore caught on a comer of the drawer, broke and scattered 
about the floor. With a sigh of relief, Miss Delano said; 
'*You go on wijh the papers uiul I'll gytUer up the beads. I'm 
so tii-ed I can't keep my mind on the work.*' 

After the personnel of a base hospital unit had been en- 
rolled, the nurses and enlisted men were required to sign in 
duplicate the muster-roll of the unit. This early system of re- 
quiring nurses to affix their signature to the muster-roll was 
later discontinued. Since nurses were members of the pro- 
fessional staff, the Surgeon General decided in 1917 that this 
troublestmie detail might well be eliminated. 

The Anjerican Red Cross entered into a definite contract 
with every parent institution which had undertaken the or- 
ganization of a base hospital unit. The following contract illus- 
trated this relation: 

The partiet* in this agreement hereinafter referred to as 
the RED CKOSS and as THE HOSPITAL shall refer to 
the American Ked Cross tuid to the Lakeside Hospital, 
Cleveland, Ohio. 

The Hospital does hereby agree to assemble from its staff 
graduates, iniri»es, employes and friends, a trained personnel 
for a iive-hundred bed Army base hospital, and to keep 
the specified posts of such a personnel filled, in accordance 
with the t^pecincatioua as made and from time to time re- 
Tised. by the Surgeon Ceneral of the United States Army. 
It also ngrees to keep in the official muster-roll and ready 
for penire. this personnel and at the call of the Ked Cniss, 
immediately assemble such persons for transportation under 
the Government orders. From time to time as vacancies 
occur, they tjhall be filled by persons nominated by the Hos- 
pital Trustecfl and the Director, and those so nominated 
shall be appointed to such vacant posts, provided they con- 
form to the prescribed regulations. At a call from the Red 
Cross for the services of this unit, the superintendent of 
the Hospital is hereby authorized and is instructed by the 
Trustees of the Hospital to release and send, wherever and 
whenever (»rdered, the enlisted personnel of this unit, and 
with the Director^ to select substitutes for any who are un- 
able to go. 

The employees sent with the Hospital unit shall not re- 
main on the Hospital pay-roll during absence, but no em- 



RELATION OF NURSING SERVICE TO THE ARMY 337 



I 



ployee of the Hospital shall be dismissed from the Hospital 
service, or fail in reinstatement at the eloae of such service, 
because of abseuce on account of the call of the luiit to active 
service. 

In consideration of the maintenance of the above personnel 
by the Hospital, the Red Cross agrees that tlie above men- 
tioned unit Bhall constitute a part of it^ reserve medical 
organization and be known by the name of the Hospital as 
well as by its official number. It is understood that after 
the calling of this unit it will be nut oi the; \le\] Cross re- 
serve organization and controlled entirely by the Govern- 
ment. Jt is also understood that, whenever this Hospital 
Unit is called out by the Red Cross or Government, that its 
entire expenses, including transportation from Cleveland, 
are to be paid either by the Ked Cross or the Government. 

EuoT VVadswortu, 
Acting Chairman, American .Red Cross. 
Samuel Mather, 
President, Lakeside Hospital. 

To the Lakeside Unit belongs the honor of being the first base 
hospital to complete its miister-rollj and also to be mobilized 
into active service. Colonel Kcau in a letter written Dr. Crile 
on July 31, 1916, gave the Lakeside Unit the designation of 
Red Cross Base Hospital Xo. 4. He stated that while National 
Headquarters had originally intended to give numerical desig- 
nations to base hospital units in the order in whitrh the com- 
pleted muster-rolls had been received, this plan bad not been 
possible on account of unexpected delays encountered in com- 
pleting the muster-rolls, especially in the column of male 
administrative personnel. *'The purchase of equipment,'* con- 
cluded C<donel Kean, "therefore began before the rolls were 
completed and it became necessary to give numbers to the base 
koepitaU in order that accounts might be opened with them 
in tliia office for the purchased property and in order that the 
equipment so purchased nnght bi^ duly marked." 

On August 1, lino, Colonel Keaii transmitted to the chair- 
man of the Red Cross Central Committee the tvmplcted muster^ 
roll of American Red Cross Base Hospital No. 4 (Lakeside) 
with tlie recommendation that "this unit be enrolled in the 
office of the Surgeon General, U. S. A., under Paragraph 16, 
Circular No. 8, S. G, O. September 10, 1012." On the same 
diy, Major General Arthur Jlurray, U. S. A. Retired, then 
chairman of the Central Committee, forwarded the muster- 



838 HISTORY OF AMERICAN RED CROSS NURSING 



roll and Colouel Kean's letter to the Adjutant General, for 
transmittal to General Gorgas. Ou August 5, the Surgeon 
General informed the Ked Cross that "the receipt of muster-iu 
roll of Base Hospital No. 4 (Lakeside) Clevelaudj Ohio, Dr. 
George W. Crile, Director, is acknowledged. The same has 
'been placed upon the records for future reference." Thus in 
;ieompl('te readiness for imuiediate mobilization upon future 
IJieed, the first one of that subsequently long list of Red Cross 
IJwise hospitals was entered among the reserve personnel of the 
-United States War Department. A list of these units may be 
found in the Appendix. 

In addition to tbese lirst fifty base hospital units, the Nur»- 
ig Service supplied twenty nurses to serve on the staff of 
Base Hospital No. 55 which was organized by Dr. Baleh, of 
Boston, Mass. Jessie Grant was chief nurse of this unit. 
Two other units, which were designnted as Supplementary 
and as lieplacement HoHpitnla, each had their full eonipleuient 
of one hundnnl inirsea furnished by the Red Cross^ but these 
Vnits acted as a reserA'c in furnishing nura<»s for other hospitals 
and BO were not regularly organized as Red Cross Imse hos- 
pitals. Another unit, called the British Base Hospital, had its 
-jiurses furnished by the Ameri<'an Red Cross with the detinite 
destination of service in England in view. 

After the completed muster-rolls of several base hospitals 

had been fiU-d in the War Department and the e<|uipnicut for 

each bad b<'en stored in warehouses provided l>y the Govern- 

^^ent and the Red Cross, National lleadtiunrtera desired to 

.^»e how these "canm-d hospitals" wouKl nK'<t the test of actual 

iinobilization. The National Committc»e on Red Cross ^ledi- 

[cal Service at a meeting held June 15, lOlG, requested the 

* merican Red Cross to order out on October 2S one of its 

mse hospital units in Philadelphia. Colonel Kean stated that 

**the purpose of this mobilization was primarily to demonstrate 

that the organization existing on paper was a practical and 

serviceable one; secondly, to ascertain what difficulties would 

stand in the way of such a mobilization; und thirdly, for the 

instruction in medical preparedness of the great body of sur- 

'gecuis who would be in Philadelphia at that time, in attendaneo 

upon the Clinical Congress of Surgeons and the American 

College of Surgeons." *" 

Base Hospital No. 4 was selected for trial mobilization. On 

"American Red CroM Annual Report, 1016, p. 30. 



I 



RELATION OF NURSING SERVICE TO THE ARMY 339 

the brow of picturcsijiie Belmout Plateau, Fairmont Park, Phil- 
adelphia, Pa., Base Hospital ^o. 4 mobilized on October 28, 
191i», under eighty-five dun-eolored Army tents. Twenty- 
five nurses, witli Grace Allison as chief nurse, rei>orted, bnt 
no nurses' aides were present, owing to a decision not to call 
them out. The camp, covering twelve acres, had been erected 
by a detachment of the Medical Department sent over from 
Washington, D, C, under the command of Major Harold W. 
Jones. Twentv-four hours after the arrival of the nurses, all 
vards were iu readiness for patients. 

Tents are not the most satistactory housing equipment for 
"so large and sedentary an organization as a base hospital." 
On exhibition at Fairmont Park was a splendid model showing 
the arrangement and materials of an ideal base hospital, created 
nnder the supervision of Dr. George E. Brewer, of New York, 
and hie assistant, Dr. Sidney R. Burnnp. 

Colonel Keau summarized the benefits derived from the trial 
mobilization of Base Hospital No. 4: 

The mobilization of this hospital marks an epoch in Bed 
Cros.s development as concerns its obligations to assist the 
medical service of the armed forces in time of war. It is 
the first practical and concrete demonstration of the ability 
of the Red Cross to do this. It takes the scheme of Ked 
Cross military units as a part of the Medical Service out 
of the domain of theory into that of nceompliehed fart. The 
cost of this mobilization was in all SSOSS.tS. The freight 
on equipment and incidentals, .$365.15, was paid for by the 
New York County Chapter.^* 

During the fall of 1910 and throughout the year 1917, Miss 
Noyes carried practically alone the work of organizing the 
niirsing stalls of the first fifty base hospitals, a task fraught 
with extensive detail. 

In the orgiiniziition and e(|uipuient of its base hospitals for 
the Army, including a total personnel of 4.197 nurses, the Red 
Cross accomplished the greatest single project of medical and 
nursing preparedness in history. The amount of time required 
to purchase the equipment of Base Hospitals Nos. 1 and 2 
in New York in iime of peace, without any restrictions of funds 
or military "red tape" amounted to four months. Advocates 
of preparedness felt that economic conditions existing in a 

* American Red Cross Annual Report, 1916, p. 30. 



340 HISTORY OF AMERICAN RED CROSS NURSING 



nation at war would greatly increase the period necessary for 
these mechanical arrangements. "Therefore," argued Colonel 
Kean, "if we are to have hase hospitals ready to take care of 
our soldiers when war coiues, we nnist eciiiip them in time of 
peace." Theoretically, it was iiiidoiibtcdly the duty of the 
Govcrnmen). to provide base hospitals. The fighting branch 
of the Army had always lacked many things, however, which 
perforce had to be asked for in preference to base hospital 
equipment ''Rifles, cannon, munitions, tentage, clothing, 
transport service have to he provided before we can have an 
army and naturally take precedence over provision for the care 
of the sick and wounded." ^** Here lay a supreme opportunity 
for the American Ked Cross, uuliampered by lack of funds, 
poasessed of flexibility of organization, blessed with popular 
appeal. 

Only the larger civil hospitals in the principal cities of the 
United States maintained staffs of sivfficient size and specializa- 
tion to permit the organization of a base hospital. Many small 
institutions, however, wore also eager to organize Red Ctoss 
units. To accept their offers of assistance which came di- 
rectly to the Red Cross or were referred thereto by the War 
Department, and to utilize the hospital facilities of the entire 
country, the War Department authorized the organization of 
smaller units of about one-half the size of a base hospital, to 
be known as hospital units. The Regulations Governing the 
Employment of the American Red Cross in Time of War (De- 
ceml)er IS, IDIK) stated in Paragraph Thirteen that '^hospital 
units are intentled to BU{)plement and assist established mili- 
tary hospitals. Sections of hospital units may also be assigned 
to duty on hospital trains and ships and to other military sani- 
tary organizations." 

The staff of a hospital unit was made up of **a director; gn 
adjutant; two chiefs of service; four staff physicians; one head 
nurse; twenty nurses; three clerks, who may be women; and 
such numbers of orderlies as may be necessary." 

The method by whi<'h hospital units were organized wna simi- 
lar to that used for their bigger brother, the base hospital. The 
equipment of hospital units included only instruments, medical 
and surgical supplies, basins, cushions, brushes, buckets, frac- 
ture apparatus, splints, aiul similar articles. As the purpose 
of these units was to supplement established institutions, all 

"See A. R. C. AnnuaJ Report, 1910. p. 31. 



RELATION OF NURSING SERVICE TO THE ARMY 341 



I 



I 



permanent articles audi as furniture, refrigerating and deloua- 
ing plants and X-ray apparatus were omitted, lied Cross 
Chapters in the cities where hospital units were organized, pro- 
vided and stored their ecjuipmeut and prepared tlieir quotiis of 
surgical dressings. Perishable supplies were often purchased 
from the stock of the parent institution when the hospital unit 
was ordered into active service. Complete equipment fur a 
Lobpital unit w^as estimated to cost approximately $2500. 

National Headquarters organized nineteen hospital units 
which were assigned to active ser^'ice with the United States 
Army during the European War. The nursiug stafFs of these 
units were composed of ti*,iO American Red Cross nurses, who 
serred na ^e8P^^'e8 of the Army Nurse (V)rps. A complete list 
of these units may be found in the Appendix. 

Although surgical sections were a type of unit which Secre- 
tary Baker authorized the Red Cross to organize in the Regula- 
tiona Governing the Employment of the American Red Cross 
in Time of War (December 18, 1916) only one such unit was 
organized by National Headquarters. It was designated as 
Surgical Section No. 1 and was organized under Dr. E. M. 
Quaiu, of Bismarck, North Dakota. 

Emergency detachments, made up solely of nurses, wore the 
illeat and the most numerous of the three early Red Cross 
units. As early as June 22, 1016, Miss Delano wrote to all 
Stat^ and l.K)cal Committees on Red Cross Nairsing Service, 
explaining the purpose of emergency detachments and charge 
ing the State and Local Conmiittee members with the responsi- 
bility of developing one or more of these units. The Regu- 
lations Governing the Emplovment of the American Red Cross 
in Time of War (December 18, 1916) stated in Paragraph 
Fifteen that "emergency detachments of nurses are organized 
to meet sudden calls from the sanitary' service of the Army, 
or other emergencies. They will be used to supplement the 
nursing servi^ce of military hospitals already established, or 
be assigned to duty on hospital ships, hospital trains, or any 
•enrice where groups of nurses may be needed. . . , Each 
detachment,*' concluded the paragraph, "consists of ten nurses, 
Ctue of whom mav be designated as head nurse and acts as such 
until the group is assigned to duty under the supervision of an 
Artny cljief nurse, when her duties will be the same as those 
of other members of tlie detachment." 

Organization of emergency detachments was first carried on 



842 HISTORY OF AMERICAN RED CROSS NURSING 



by direct correspfindyufe IxAtween tbe Bureau of Nursing at 
Nationul Huadquurteirs and L<icul 0(»mniitU'n8 on lied Cross 
Nursing S<'rvit*c. This profcdiirc continued until tlie full of 
1917, whon the thirteen lied Cross Division offices were 
created ; the Diviaon Directors of Nursing then took over the 
details of i^ecniiting wJiioh hnd previously been handled by 
J^fiss Noyes and her assistant^.-' 

With its absence of equipment, its ease of mobilization, its 
ability to respond iniTncdialely to duty upon the receipt of its 
orders into active service, tlic emergency detachment proved one 
of the most valuable methods through which nurses were se- 
cured. The first of tlieso g:*oups was ordered into duty on 
the ilexicun bonier in July, IDKi, Many others were assigned 
during 1917 and the early mouths of 1918 directly to tho 
British and American Expeditionary Forces. Later, however, 
nurses from these units were sent to cantonments where they 
were prepared for overseas duty. Red Cross emergency de- 
tachments supplied 11,470 nurses to the War Department, half 
the entire strength of the Army Nurse Corps. No more bril- 
liant proof than this can be found of the soundness of the Red 
Cross Nursing Service committee system, nor of the untiring 

Eatriotism of these nurse-members, who, although already over- 
urdened with tasks of maintauiing with inadequate persounel 
hospitals and training schiMils and other types of work, served 
as volunteers during every available moment on the Local 
Connnittees wliicli brought these eleven thousand nurses into 
the military service. 

The youugest members of the nursing profession to serve 
with the Amerieiin Army during the European War entered 
the Anny Nurse Corps by joining training school units which 
the Ked Cross organized within the senior classes of hospital 
schools of nursing. An unusually attractive group they were, 
young, adventure-loving, a brave and eager company of whom 
almost all were of recognized dependability and skill. 

Red Cross base hospitals and hospital units, made up of the 
members of stalls of major civilian institutions in all parts of 
tlie countrv, had drawn, during 1917, hundreds of nurses of 
distinguished positions from the inatittitional field. Local 
Committees on Red Cross Nursing Service were combing grad- 
uate nurses' associattouSy clubs, registries and other ageuciea 



"See letter written November 1. 1017. by C 
Lociil Committece and orgftnUing nursea. 



Kuycs (o all State and 




I 



RELATION OF NURSING SERVICE TO THE ARMY 8W 

for private duty nurses to servt* especially in emergency de- 
lAc^ments. With these tields of supply almost exhausted in 
the spring of 1018, Mias Delauo and Miss Noyes appealed to 
members of the Juno graduating classes of hospital schools of 
Bursing, uiging these young women also to join that continuous 
proocsaion of reserve nurses filing into the Army Nurse Corps 
throogfa the American Red Cross. 

Mis0 Delano presented in a letter written March 12, 1918, to 
all snperintondents of schools of nursing, the iirst step of 
the Red Cross plan to utilize the services of young graduates 
for the Army; 

We have been definitely aRked hy the Surgeon General to 
supply five thouKftiul nurses by June 1, liUS, for the Army 
' alone, and it is estimated that pmhnbly not far from thirty 

thousand ndtlitinnal ones will ha needed by January 1, lOli). 
, . . It seems evident from the recent surveys which have 
been made of the nursing resources of the country that there 
are not more than eixty-iive thousand registered nurses in 
the United States. . . . 

We believe that training school superiuteiidenta are most 
aiuious to aid in every possible vr&y to secure tlie number 
of nurses needed. One of the most practical methods of 
increasing the available supply of nurses is to advance some- 
what the date of graduation in training schools giving a 
three years' course of training, provided of course that only 
such nurses should be graduated as are willing to enroll 
promptly with the Red Cross and accept service at once 

th the Army or with the Navy. . . . 

I should not feel justified in urging this shortening of 
le regular three years' course, if I did not believe that the 
experience in militnry hospitals would supplement their 
regular training and give them not only experience which 
will be of value to them in their career as nurses, but would 
give them as well the satisfaction of having served their 
country in time of need. 

On March 13, 1918, Miss Noycs followed up Miss Delano's 
Vtter with a personal communication addressed to all superin- 
tPTjdoTits, in which she urged them to undertake the organiza- 
tion of at least one training school unit 

The underlying principle of organizing such units was a 
recognition of the clan instinct. War scorned less formidable 
ivben B nurse could go out with a former room-mate or a friend 
who bftd been trained in the same wards. 



844 raSTORY OF AMERICAN RED CROSS NURSING 



Each train iug school unit was nnmberedj the designation 
begiiniing with a hif^h iiuirih(?r to Jivoid eoiifuHJou with base 
hospitula and liospital units. Tin? first, training school unit 
was formed at Sara Elizaheth Hoapit^il, Henderson, North Car- 
olina, and was designated T. S. Unit No. 500; tho second, from 
the Methodist Episcopal Hospital, Brooklyn, New York, as 
T. S. Unit No. 501. Nurses other tiian the graduates of a given 
school which had formed a unit might join the unit of that 
institution if none existed in their own school, or if satis- 
factory reasons were presented, but this was seldom done. 

During tho spring and summer of lOlS, 1362 nurses volun- 
teered for war service in 307 training school units. A list of 
the units is given in the Appendix. 

Immediately following the declaration of war by the United 
States, General Oorgus organized within the !Arcdical Corps of 
the Army, divisions of Mental Diseases, Internal ilediciue, 
Orthopedics and Opthaluiology, the directors of which were 
experts in these different branches of medical practice. These 
directors were charged with the responsibility of organizing 
such base hospitals for service in the United States and abroad 
B8 the treatment of such cases as might fall under the above 
classifications, required. 

The medical and enlisted personnel of these units was or- 
ganized entirely within the Surgeon Genernra office and tho 
equipment was supplied by the Government, but the Army 
Nurse C'orps called upon the Red Cross to supply the nurses. 
The first step in securing nurses qualified for this service lay 
in the establishment of a classitied list of nurses specially 
trained in pediatric, psycLopathic and orthopedic nursing and 
in nursing mental diseases, contagious diseases, head and nock 
surgery and eye and car work. After the establishment of this 
list, the procedure was comparatively simple. From time to 
time, Miss Thompson notified Miss Noyes of the formation of 
special hospitals and she secured the nurses through corre- 
spondence with those whoso names appeared on the classified 
listB. 

The development of physio-therapy, one of the signal de- 
velopments which the war indirectly brought to medical 
Boience, created a demand for expert masseuses. Miss Noyce 
prepared a form hotter in November, 1917, to l»e sent to nurses 
who rtHiuesled iriformati<»n of this t^^io from National Head- 
quartersy or to nurses whose enrollment showed special training; 



RELATION OF NURSING SERVICE TO THE ARMY 345 



I 



Begvlatious conceruing enrollment as an expert masseuse were 
as follows: 

Applicants should be graduates of a recognized school of 
massage. 

The service is entered for the period of the war. It is to 
be performed in the wards of the reconstruction hospitals 
under the supervision of the head nurse of the ward. 

Applicants should be preferably between the ages of 
twenty-tive and forty-five. 

Applicants should be endorsed by the principal of the 
school of mnsKft^e from whicli she received her diploma. 

Members of the service are expected to respond promptly 
to a call for service coming from the Bureau of Nursing of 
the Red Cross, 

A masseuse will be paid $50.00 a month, with mainte- 
nance and tranRportatioD, 

[Here follow the same passport and physical examination 
instructions as apply to the Red Cross Nursing Service.] 

The Nursing Service assigned 193 nurses expert in the care 
of special diseases to the Anny Nurse Corps for service in the 
following special base hospitals of the Medicjil Dopartraent: 
No. 114, Orthopedic (assigiuMl to service in the United States 
tnd later to foreign duty) ; No. 115, Eye and Ear (assigned 
to service in the United States and later to foreign duty) ; 
No. 116, Fracture (assigned to service abroad) ; No. 117, Psy- 
chiatric (assigned to service abroad) ; a mobile operating unit 
under Major P. R. Turnure, M. K. G. of New York City. 

A« the Selective Draft brought thousands of recruits to the 
cantonments, which had sprung \ip o%-emight in rows of un- 
painted barracks like clusters of enormous gray mushrooms, 
t problem in sanitation arose which presented an opportunity 
to tlie Red Cross for vital service to the enlisted man. Within 
the military boundaries of each cantonment, sanitary measures 
were directh' under the charge of Army Medioal officers. In 
Ae regions imuiodiately surrounding the military district, this 
responsibility was divided between State, county and municipal 
health departments. The physical well-being of the new 
armies was intimately related, however, to these extra-oanton- 
mcnt zones. Through the coiiperation of the War and Treasury 
Departments, the United States Public Health Service had 
agiWd to assign an expi'rienced sanitarian of its staff to auper- 
Tbe health measures about each cantonment. This officer was 



346 HISTORY OF AMERICAN RED CROSS NURSING 

duly invested with such powers as the State and Local Boards 
of Health would transfer. 

iCeither the Federal Public Health Servire, nor loeal agencies 
possessed, however, sufficient funds to employ an a*UH|\iate 
personnel to help this officer. Legislative action would have 
consumed valuable time. The Red Cross accordingly set aside 
an initial appropriation of over $10,000 to organize ■ 
Bureau of Sanitary Service under the Department of Military 
Relief and supplemented this appropriation from time to time 
to the amount of approximately $7r»0,000 in the aggregate. 

Dr. Taliaferro Clark, Surgeon, United States Health Service, 
and one-time director of the Red Cross Bureau of Sanitary 
Service, stated in the Annual Report of 1917, the method 
under which this bureau operated: 

Assistance is given only on request from a State and on 
recommendation of the Surgeon General of the United 
States Public Health Service, under whose direction a sani- 
tary survey is being made in the vicinity of each canton- 
ment. 

Upon receipt of a report from the Public Health Service 
stating the conditions in a district and establishing the need 
for aid, the Hed Cross promptly furnishes this supplemen- 
tary assistance by assigning to the district bacteriologists, 
sanitary inspectors and lied Cn^ss public health nurses, with 
an appro|>nation sunicicnt to provide equipment, transjiorta- 
tion and maintenance. 

Miss Noycs w*rote on August fi, 1917, to chief nurses of all 
units and dctachnu'uts, stating that tbi5 National Comuiittce on 
Kcd Cnjss Nursing Service hud voted the week before in favor 
-of a special enrolbncnt fi»r public health nurses, exempting 
'them from active militiny service, if they desired, so that thoy 
might undertake cantonment 7,one work. Miss Noyes suggested 
that all nurses who were enrolled in base hospital and other 
units, yet who by training and experience were titled for can- 
tonment zone service, should be withdrawn from the units then 
oeing organized for the Army and should be transferred to 
cantonment zone service. 

This particular phase of war nursing surrounding the can- 
tonments coitsisted in sanitary work in connection with the 
public and private water supply; the disposal of sewage and 
garbage; the drainage of musMjuito-iufested swamps; tlie in- 




RELATION OF NURSING SERVICE TO THE ARMY 347 



spection of food supplioH; and tlio control of communicable 
difioases. Miss Ella Phillips Crandall. executive secretury of 
the Natioiial Organization for Public Health Nursing, assisted 
^the Red Cross in the selection of public health nurses for this 
irvice, one hundred and fifty-four of whom were assigned 
twenty-nine sanitary zones at the following localities: 
Alexandria, La. ; American Lake, Wash. ; Anniston^ Ala. ; At- 
lanta, Ga. ; Augusta, Ga. ; Aycr, Mass. ; Charlotte, N. C. ; Chat- 
tanooga, Tenn. ; Chillicothe, Ohio ; Columbia, S. C. ; Dea 
Moines, Iowa ; Manhattan, Kansas; Fort Worth, Texas; Green- 
ville, S. C. ; Hutticsburg, Miss.; Houston, Texas; Jacksonville, 
Fla. ; Loavenwortli, Kansas; Littlo Rock, Ark. ; LouiBville, Ky. ; 
Macon, Ga. ; Montgomery, Ala. ; Newport News, Va. ; Peters- 
burg, Va. ; Portaniouth and Norfolk, Va. ; San Antonio, Texas ; 
Spartanburg, S. C. ; Waco, Texas; W^rightstown, N. J. 

By vote of the National Conuuittee on Rod Cross Nursing 
Service in May, 1918, the name of the Red Cross Town and 
Country Nursing Scn'ice was changed to that of the Bureau 
of Public Health Nursing Service. To it were delegated during 
the summer of 1018 the responsibility for public health nurses 
aseigued to extra-cantonment zones. 

Second in military importance to American combat tr<x>pa 
in France were the essential war industries in the United 
States, which furnished supplies to the Americau Expeditionary 
Forces and to the Allies. For ten miles iiloiig fue Ohio River, 
in whose durk, swiftly-flowing waters were reflocLed at night 
the glaring throats of a thousand furmi.^^, stretched the United 
States Ammunition Plant at Nitro, in ilie West Virginia hills. 
From Muscle Shoals, Alabama, came the nitrate for high ex- 
►losives. Various other centers for manufacturing essential 

ir supplies were located in different parts of the country' 

id employed many thousands of workers. The health of 
thoflc men and of their families was of paramount importance, 
— for upon their lalx»r depended the output of these manufac- 
turing centers — so the (iovoninient established ba.se hospitals 
tti care for accident cases and illness which occurred there. 

The Surgeon General of the United States Public Health 
Service, under whose department these hospitals were main- 
tained, agreed to utilize for this service nurses who had been 
elif^tly below the physical requirements of the Army and Navy, 
or Uiose slightly above the maximum age limit, or married 
nunca whose husbands were in military' service, a group which 



348 HISTORY OF AMERICAN RED CROSS NURSING 



was barred from joining the Array Nurse Corps. Eighty-eight 
nurses were assigned to this service, 

To Marine llospitals and to special institutions maintained 
by the United States Public Health Service for the care of 
pellagra, trachoma and other contagious diseases, fifty-four Red 
Cross nurses were assigned before the Armistice. The develop- 
ment of the Nurse Corps of the Public Health Service is treated 
more fully in a later chapter. 

The first field service which American Red Cross nurses 
experienced as reserve members of the Army Nurse Corps was 
on the Mexican border. This type of duty began in 1011. 
In the spring of 1914-, the Ptinitive Expedition was dispatched 
to Vera Cruz and occupied the city. Army nurses accompanied 
the military forces. Early in 1016, the Villesta forces killed 
several American miners and the United States Government 
demanded reparation. On March 0, 1016, V^illa invaded 
Columbus, New Mexico, killed seven troopers and several 
civilians and fired many buildings. President Wilson then 
ordered a punitive expedition under ^'Black Jack" Pershing 
to cross the border in pursuit of Villa, but to respect scnipu- 
lously the sovereignity of the Mexican Republic. Pershing, 
with the aid of Carrauzu*8 troops, drove Villa into the hills, 
but the chaotic state of anarchy existing in Mexico continued. 

In June» President Wils^ui changed his policy of "watchful 
waiting" to one of border defense; in a note of June 2, 1010, 
sent to all factions, he warned them that tliey must adjust 
their differences and **act promptly for the relief and redemp- 
tion of their prostrate country" or else the United States would 
bo "constrained to decide what means should be employed to 
help Mexico save herself." On June 12, two troops of U. S, 
cavalry (colored) approached the town of Carrizal, requested 
permission of General Gomez to pass, stopped at his suggestion 
to confer and were fired upon by the Mexican forces. A number 
of soldiers, incinding the oftieer in command, were killed and 
twenty-four were taken prisoners. President Wilson imme- 
diatelv demanded that Carranza define his attitude and sur- 
render the prisoners. On June 18, he called out every militia- 
man in the t^nitin] States to strengthen Pershing's line of 12,000 
Regulars which extended '280 miles directly soutb to Nami- 
quipa. tSixteeu baUleshipa steamed to the Mexican coast. 
Congress oflicially authorized the President to draft the Na- 



. 



RELATION OF NURSING SERMCE TO THE ARMY 349 



tkmal Guard into Federal .service and voted $2fl,O00jO0O for 
tke emergency. Carranza then yielded and returned the pris- 
Notes proposing diplomatic settlement of the differ- 
between Mejrico and the Lnited States were exchanged 
in July. At this juncture, Villa cmci^rd from among the 
hills and the **cat and mouse" warfare ihat had been going on 
before began again. 

With over 200,000 Regulars and Militiamen in the field in 
August, 1916, the United States Army established during the 
aununer fire base hospitals, five camp hospitals and one can- 
tonment hospital along the Mexican border.-- Kathrine Don- 
nellj. Lulu T. Lloyd, Alice B. Han-ey and Nannie B, Hardy, 
re«?rve members of the Army Nurse Corps, had been in 
service with the border troops since 1014. When the rola- 
tioDs between Mexico and the United States became strained 
in the spring of 1916, Colonel Kean, then acting chairman 
of the Central Committee of the American Red Cross, wrote 
May 15 to the Surgeon General, offering the services of "such 

number of nurses, not exceeding forty, as may be needed." 

le Red Cross at the same time olTered to pay the salaries of 
'ikflBB nurses and to furnish trans ptirtat ion for them to the 
I^aoe of service, but the Aran- to furnish maintenance. "It 
ifl presumed," concluded Colonel Kean, *'that after Jtily 1 these 
nurses can l>e paid from the Army appropriation if their ser- 
vicee are still needed." Rod Cross records show no evidence 
of a written reply to this offer. 

Colonel Kean took up the question again in a letter ad- 
dressed July 28 to Colonel Birmingham, then Acting Surgeon 
GeneraL This letter contained interesting arguments of the 
three ways in which the number of nurses available for the 
Medical Corps might be increased. The first way was to in- 
crease the number of nurses in the Regular Nurse Corps. The 
neond way was to call reserve nurses, namely, American Red 
Cro«8 nurses, into active service in the Army Nurse Corps. 
The third way was to employ contract nurses *'who may or 
may not be enrolled Red Cross nurses," stated Colonel Kean, 
"but who are paid out of the Medical and Hospital Appropria- 
tion." 

The first method, that of increasing the number of nurses 
in the Regular Nurse Corps, was then being used to secure 
nurses for the Army base hospitals on the Mexican border. 

■Report of the Surgeon Ocnernl, U. S. A., 1017, p. 23. 



850 HISTORY OF AMERICAN RED CROSS NURSING 

"I do not know," ar^riied Colonel Kean in his letter of July 28, 
'Svhat advantages it has which Lave led to its adoption in 
preference to the second method^ in an emergency which is 
of a more or less temporary nature, but I think it is clear tbat. 
it has the disadvantage of being much slower than calling out 
the reserve nurses. I understand that only 100 out of tlie 
more than 400 which are now authorized, have been obtained 
during the numher of weeks since an increase was authorized. 
Alsfi, I do not believe/' he continued further, "that the l»csl 
nurses in the country are as easily secured for a permanent 
engagement in the Army Nursing Service as can be 8e<Mired 
by the selwtion from the Reserve. In the latter^ as you know, 
a very large number is available from which to select, and there 
is the appeal of patriotic service which is not so much in 
evidence in the Army." 

Colonel Kean's argument next dealt with the third method, 
the employment of nurses by contract. In his opinion, it had 
several disadvantages. "In the first phiee," he stated, "the term 
'contract nurse* is one which was brought into discredit during 
the Spanish- American War by the emplovment in this way of 
untrained nurses and of women for matrons and other purposed 
than special nursing, and the term ^contract nurse/ like 'eon- 
tract doctor/ is itself not an attractive one. Also, tlie fact 
that these nurses are paid out of the Medical and Hospital 
Appropriation, which is never too large, rather than from the 
appropriation for pay of the Army, is a serious disadvantage. 
1 think, therefore," he declared, "that this method of securing 
nurses should not be considered." 

After a discussion of the probable number of nurses needed, 
which Colonel Kean estimated would ultimately be one thou- 
sand, he proceeded with directness to his conchision: "I am 
writing to suggest that the additional nurses needed in the 
present emergency, due to the calling out of the National Guard 
and the mobilization of the Army on the border, be furnished 
from the nurses* Reserve, as is contemplated by the Regulations, 
and that this oiliee l>e taken into the confident of the Surgeon 
Generars oHieo as far as possible and notified as much in 
advance as may lx» practicable of the calls which may b? made 
upon it for nurses." 

On July 2!>, lOlfi, the Snr|?con Oeneral replied to Colonel 
Kean, requesting that "this uttice be fumisluHl with the names 
of forty reserve nurses in groups of about ten, who are willing 




RELATION OF NURSING SERVICE TO THE ARMY 351 

to be assigned to active duty in the Military Estoblishmont and 
rho can n^apond tti an iiiiiiu'diate call." In this letter, the 
SurgiMin General also stated that the physical examiiiiition 
required by the Red C Voss for ennillnient would Ix* satisfactory, 
but he requested that the credentials of each nurse assigned 
to meet this call should be sent to his office. 

Insight into the reasons why the War Department did not 
accept earlier the offer of Red Cross assistance was contuined 
in a letter written by Miss Delano August 10 to Mrs. William 
K, Draper: 

. . , The Red Cross offer, to send forty or fxftj'' nurses to 
the border, went to the War Department and after much 
discussion it was decided by the Secretary of War, I believe, 
that the Army could not accept this contribution from the 
Red Cross e-uvpt when war was actually decluriid. Their 
appropriation for additional nurses is now available and we 
have again offered to scud nurses as they are needed. 

I believe that at present there is some quet^tion concerning 
quarters, but at any rate the nurses are ready. I began some 
time ago the development of what we call emergency de- 
tachments of which we now have a good many available. 
Our base hospitals are well developed, nearly ready for f:erv- 
ice. 1 thank Heaven every day thnt we were fortunate 
enough in beginning the organization of the Nursing Service 
m long ago that now there need be no delay as far as the 
nurt'es are concerned. 

Four days later, August 14, the Surgeon General called upon 
the Red Cn.)S8 for one hundred nurses, instead of forty, for 
border service. As this was the first call of sizable dimensions 

hicli the Ked Cross Nursing Service had received, the rules 
and regulations handed down by the Surgeon General are of 
imjx»rtauce, in that they constituted the precedi'ut which later 
governed the assigiinient of American I^ed Cross nurses to 
the Army Nurse Corps during the participation of the United 
States in the Knrojxan War. In his letter of August 14, the 
Surgr^>n General stated that reserve nurses must be citizens of 
the United States. Colonel Kean in his reply of August 16 
wrote; 

2. The requirement mentioned in your letter, which is a 
new one as far as reserve nurses are concerned, — that rcperve 
nurses must be citizens. — may delay sDnu^what the calling 
out of the emergency detachments, as the question of citizen* 



362 HISTORY OF AMERICAN RED CROSS NURSING 

ship has to be put to each individual nurse. The War Belief 
Board, of which the Surgeon General of the Army and tlie 
Surgeon General of the Navy are nienil>ers, have considered 
the regulations for enrollment in the Kcd Cross Reserve and 
have not eousidered thia requirement uecessary for reserve 
nurses, whose service is of a more or less temporar}* char- 
acter, although it is required of memhnrs of the Army Nurse 
Corps. They have always, of course, been required to take 
the oath of allegiance. This requirement seems somewhat 
at variance with the neutral and intcruatioual character of 
the Red Cross. 

In his letter of August 16, Colonel Kean next dealt with 
two questions of only t(nnpc»ral importance. He suggested that 
nurses assigned to border *lnty Iwi peruutted to serve for a 
period of ouly six nuintha, if necessary, so that tliey might 
return to positions which were being held open for them. He 
also requested that several reserve nurses from various base 
hospital units be assigned to the Ixtnler, so that they might 
become familiar with Army paper work and other couditions 
peculiar to Array nursing. The last point made in this letter 
was one of vital importance. Colonel Kean wrote: 

6. As the question of insignia for Red Cross nurses when 
on active duty has not been authoritatively settled, it is re- 
quested that a ruling be made tliat they shall wear the Re- 
serve cap with the Med Cross on the front and the Red Cross 
cape which is issued to them gratis. This is considered of 
importance on account of the international and well-accepted 
character of this insiguia and its value iu maiutaiuiug esprit 
de corps. 

In a letter written August 18, the Acting Surgeon General, 
Colonel Rirminghnm, answered these points in the following 
order and manner: 

1. Your letter of August 16 is herewith acknowledged. 

2. As tliere appears to he no law retjuiring the reserve 
nurses assigned to active duty in the Military Estahlisliment 
to be citizens of the United States, so much of letter dated 
August 11 as pertains to thia need not be regarded, though 
citizens, or those who have made declaration of intention to 
become such, will be given precedence. 

3. You are authorizcnl to inform reserve nurses volunteer- 
ing for active service that they may on request, be relieved 
from active duty and given transportation, to the place from 



RELATION OF NURSING SERVICE TO THE ARMY 353 



whidi Uiey started, at the end of &ix mouths' service, unless 
in the meantime, the need for their service ceases to exist or 
in case of misconduct. 

4. Id the case of uurses assigned to active duty, and who 
are enrolled for base hospital units, every etfort will be made 
to transfer them to iho unit of which they arc a part, should 
the unit be called out, provided the Bed Cross will nominate 
other nurses to replace them. 

5. There is no objection iu this office to the use of the 
Red Cross cape and cap by reserve nurses. 



■ Immediately upon receipt of Col. Birmingham's answer, 

™ Miss Delano called out emergency detachments which had been 

organized by Ix>cal Committees in Alabama, Colorado, Georgia, 

I Nebraska, Iowa, Louisiana, Maryland, Minnesota, New Jersey, 
New York, Ohio, Pennsylvania, Texas, Virginia and Wash- 
ington^ D. C, One hundred and forty-four nurses were first 
assigned to Camp McAllcn, Port Sam Houston, Eagle Pass, 
Laredo, Llano Grande, Brownsville and Fort Bliss in Texas; 
to Nogales and Douglas, Arizona; and to Deming, New Mexico. 
Nurses were also assigned to United States Army base hos- 
pitals from the base hospital units organized at Bellevue, the 
Presbyterian, the New York City, the Post Graduate, Mt. 
Sinai and the German Hospital, of New York City; at the 
Boston City, tJic Maasacliusetts General and the Peter Bent 

IBrigham, of Boston; at the Lakeside, of Clevidand; at the 
Rochester Hospital, of Rochester, New York; at the Harpt^r 
Hospital, of Detroit, Michigan; and at the Washington Uui- 
versily Medical Schmjl, of St. Louis, Missouri. 
Reserve nurses who went to the lM)rder were almost unani- 
mous in their expression of enjoyment of the service. The 
chief nurses were Regulars of the Army Nurse Corps. Au 

• eight-hour day gave the nurses ample li'isure. The work in 
ititf'lf was light, but the Hcsrrvt'H found unending iiitfrrst in the 
routine of an Army General HtispitaL "The Military is so 

t different I" they wrote Miss Delano. 
At Fort Sara Houston, San Antonio, Texas, the base hos- 
pital of one thousand beds was always fuIL "The patients are 
mostly typhoid and op<»rative cases and soldiers suffering from 
exhaustion due to the hot sun," wrote Ada Ha^-ton, of the 
Washington, D. C, emergency detachment, to Miss Delano. 
Elizabeth E. O'Keefe, another reserve nurse, wrote of the 
itnde vnth which visitors and patients regarded the Reserve: 




35^ HISTORY OF AMERICAN RED CROSS NURSING 

I We are quite amused at the terms applied to us by the 

I soldiers and their visitors to designnte us from the Army 

I Durses. A young woman visiting one of the ward?, stopped 

I m& to say *'I want to ask you a question, and if you are not 

I allowed to answer it, why just say so, won't you?'* I no<ldefl. 

I Imagine my surprise w!»en she drew a long breath, screwed 

I up her courage and whispered confidentially: *"You Red 

I Cross nurses aren't really all graduate nurses, now, are you?" 

I A patient said to one of the Reserves, as ghe was giving 
him a bath: "Do you find this work very hard to learn?" 
**WImt do you mean?" she asked. "Why/* he replied. 

I ^'aren't you one of those society women who are doing this 

I for fun and tlie good of humanity?" 

At Fort Bliss, Texaa, the Army base hospital cared for an 
average of five hundred patients, the majority of them accideut 
cases. Here as in other bases, the nurses were at first somewhat 
uncertain as to their exact dutioe. "^^After we get better 
acquainted with the x\rmy," wrote Ellen Thomas to Miss Delano 
on Septemlx*r 12, 1916, ''I think we will be busier. The Corps 
men have done all the work until June of this year and it is 
now rather dilHcult to know where their work stops and ours 
begins." 

Overlooking the low brush and cacti of the Mexican shore, 
directly en the bank of the Rio Grande, stood the Brownsville 
Hospital. In a letter written September 28, 1916, to Miss 
Delano, Edith L, Wood, reserve nurse, described their 
"quarters" : 

We are fairly comfortably situated here in a low frame 
building, just boards, with two of us in each room. Every- 
thing 18 screened against mosquitoes and we sleep under nets. 
Though the heat is intense during the day, the wind off the 
Gwlf of Mexico, twenty miles away, makes our nights very 
eomfortahle. 

All the buildings are of the same construction. The wards 
accommodate about fifty patients each. They are so quiiJily 
and easily assembled that tliey scorn to spring up overnight 
like mushrooms. A mouth ago there was nothing here but 
duHt, saudlleas, cacti and heat. Now it looks like a small 
village. 

No special disease prevails. We have something of every- 
thing, quite a bit of malaria, and a fever called "dengue," 
which the merry mosquitoes give us. 



RELATION OF XL USING SERVICE TO THE ARMY 355 

One of tlie five camp boepitula which thi? Medical Corps 
maintained on the bt»rdcr was lorattMl at Llano (iraiulc, Texas. 
A re«enre nurse who had sc<^n survice with tho British Plxpedi- 
dooary Forces during the early years of the European War 
inole of the work at Llano Grande : 

Our experiences arc quite different from those in an Eng- 
lish camp hospital in France. We were much disai)pointefl 
at first to find our hoepital so poorly equipped. Camp life 
in France was so very fascinating and the nurses were 
treated with great respect by the British Tommies. . . . 

We were later transferred to Fort Sam Houston, where 
everything is well evstematizcd, with supplies in abundance. 
Here we found our l>oys quite as appreciative as the Eughsh 
And French and so full of fun ! 

The camp hospital at Douglas, Arizona, consisted of tents 
and wooden barracks. "Nurses* quarters/' wrote Harriet Han- 
kitu to Miss Delano on August 27, 1916, ''*are separate and 
are built of wood, with excellent floors, plenty of screened 
windows, running water, in fact arc wonderfully comfortable. 
Kach nurse has a lx?d, a bureau and a built-in wardrobe." Miss 
Delano's reply was reminiscent of her own early experiences 
in the West: "Soon after my graduation," she wrote, "and 
almnet my first work was in the mining camp at Bisbee, Arizona, 
not far from your present assignment. In tiiose days, the 
Apache Indians were usually on the war-path and we never 
dared stir out without a revolver. I imagine things are more 
civilizi-d no\y." 

The wooden buildings and tents at Douglas, which wore 
oomfurtuhle enough during the summer of 1010, were meager 
protection against the raw fall rains and the bitterly cold 
winters. The nurses stationed there then experienced more 
of the rigi^rs of open camp life, for a letter written hy a member 
of a Jjoeal Committeti on Red Cross Nursing Service to Miss 
Delauo gave a ditlcrcnt picture: 

Their quarters were a small tent shared by five nurses. 
There was no way of heating it; the weather was very cold. 
The nurses in the shaeke had four blankets and a stove. 
MTien it rained, the water would run under the coin. The 
flooring of the tents was earth. One very cold night the vrind 
blew up the top of the tent and the nurses gathered up their 
blankotfi and clothes and spent the rest of the utght on the 




356 HISTORY OF AMERICAN RED CROSS NURSING 

floor of the diuing-room. They used to stand on their cots to 
dress so they would not have to put their feet on the cohl 
earth." 

This first ficJd service with the Army which reserve nursea 
experienced on the Mexican lH)rtk'r wns of ^rcat vahie in 
acquainting Americnn K^d CroBs niirsos with military disci- 
pline. In her letters in reply to complaints which the nurses 
sent to National HeadqnartcrH, Miss Delano emphasized again 
and again the nuofficial connection which she held to Red Cross 
nurses nftor thoy had once l>eon assigned to the Anny Nurse 
Corps. The Red Cross could in no way interfere with the 
discipline of the Army and Navy and no one appreciated this 
fact more than did Miss Delano. To complaints, her answers 
were almost invariably as follows: 

In the first place, Ked Otosp nursofl when assi^ed to duty 
in a military lioppital become temporarily members of the 
Army Nurse Corps, subject to all rules gi)verning that service. 
It is imposftihle for me to take up this situation officially. 
Any statement should he sent through the chief nurse and 
the regular military channels. 

May I urge, however, that you keep the nurses from dis- 
cussing tliis matter and ask them to accept without question 
any decision of the chief nurse? Be patient for a little while. 
You know how deeply interested I am in everything concern- 
ing Ked Cross nurses, but when it comes to a question of 
military authority, I am quite lielpless. I can only count on 
you to do your best to keep things running smoothly. 

Though only a minor skirmish in comparison with the titanio 
struggle to come, the ^fexican l)order service of 257 reserve 
nurses remained an illuminating and, for most of them, a 
worth-while memory. 

Both from a utilitarian and from an flpsthetic point of view^ 
the uniform of the Aniericai* Army nurse on active duty during 
the European War differed greatly from the costunu's worn 
by nurses in previous wars. Volunteer and professional nurses 
of the Spanisb-Amcrican War had gone to their posts of duty 
garbed in civilian dross or in the uniform of their school of 
nursing. The appearance of the Civil War nurses, in crinoline 
and ahawl, is familiar to students of American militarj history. 

" Red Crou Archive*, Kntionnl Headqu&rtors, Wash., D. C. 



I 



B "It 

■ »^ 



RELATION OF NURSING SERVICE TO THE ARMY 357 

The description of the "grey tweed wrapper, worsted jacket 
with cap, a short woolen cloak and frightful scarf of brown. 
bolland" ''^* of Miss Nightingale's nurses calls up an awesome 
image. 

The uniform of the American Army nurse was both useful 
and attractive. It consisted of bhie norfolk coat with the bronze 
letters U. S, and the caducous of tlic Army Mcdicid Corps with 
the initials of the Army Nurse Corps sinK'rini{Mtst'd upon them, 
the short blue skirt above brown shoes, and trim sailor hat, or 
the white, one-piece dress worn willi the scarlet-liued blue 
Rod Cross cape and the winged white cap. A war eurresjxindcnt 
once asked a doughboy from a Pi^nnsylvnnia mining town, who 
had been brought into an American base hospital with a shat- 
tered leg, what he tbouglit of the reserve Array nurses there. 
"It gives me," repHod the Pcnnsylvanian, '*bcneficient shell- 



The distinctive uniform of the American nurse was, however, 
a gradual evolution. The Monnal of the Medical Department, 
IDOO, the edition in which first appear regulations regarding 
the uniform of Army nurses, stated that "the uniform of the 
Army Nurse Corps shall consist of a waist and skirt of suitable 
white material, adjustable white cuffs, bishop collar and white 
mpy according to patterns and specifications in the office of the 
Surgeon General." ^° 

At the first meeting of the National Committee on Red Cross 
Nursing Service, which was held in New York on January 20, 
1910, a committee which consisted of Miss Delano, Miss Board- 
man, Miss Nevius and Major Lynch (then in charge of Red 
Cross First Aid instruction) was appointed to draw up a cir- 
cular of informatiim regarding enrollment in the Nursing 
Servioe. This circular was printed by the National Head- 
quarters on April 1, 1910, and contained the following regula- 
tions: 

Uniform and Badge 
Fnless othcrwipc authorized, nurses called upon for service 
under tlie Ked Croats will wear plain white uniforms with 
bishop collars luul caps, the patterns of whi4'h will he provided 
by tiie American Red Cross on application to the chairman of 
the Xational Committee on Red Cross Nursing Service. . . . 
[Address follows.] 

" 'VwDoriei* of the Crimea," Sister Mary Aloyaiutt, p. 17. 
"Manual of the Medical Department, 1906, p. 31. 



358 HISTORY OF AMERICAN RED CROSS NURSING 

At the time of appoiatnieiit eadi iiuree will receive a badge 
with her name and the nninlter of the badge engraved on the 
back and a record of the panie will be kept in the National 
oilice of tlu' Hed Cross in Washington. 

UuiKt tlie Art of CongrcKs incorporating the Red Cross, 
this ba(l;ro cannot be legally worn by any other than the 
person to whom it is issued, and ifi owned by the American 
Red Cross, It t-liould be worn on the front left-hand side of 
the collar. In case of withdrawal from enrollment, the 
badge and certificate of appointment mnst be returned to the 
chairman oL* the National Committee on Red Croas Nursing 
Service. . . . [Address follows.] 

In the event of war, the Red Cross will provide all nurses 
called u]xin for active service with blue capes — bearing the 
insignia of the Red Cross. 

Miss Delano, with a rare sense of the dramatic and an ap- 
preciation of the power of sentiment, designed the cape referred 
to, which has since become perhaps the most distinguishing 
mark o£ the American nurse on active service during the 
European War. It was a circular garment of medium length, 
made of navy blue flannel and lined with scarlet, and it was 
usually worn filing back over the left shoulder. On the left 
side was a Red Cross and by reason of the high ideal of conduct 
which Miss Delano set for the enrolled nurses and the vivid 
appearance of the garment itself, luirsea grew to honor and 
love the cape and to mi ar it with soldierly pride. It s^Tnbolized 
for them the ronninee and the sacrifice of war nursing. 

Xhc use of the Red Cross brassard was outlined in the original 
Treaty of Geneva and wns defined in the revised Treaty of 
Geneva, which was signed July 6, 1906: 

Article 20. The personnel protected in virtue of the first 
paragraph of article nine and articles ten and eleven, will 
wear attached to the left arm a brassard hearing a red cross 
on a wliilL' *rrouiid, which will be is^sued and stampeii by 
competent military authority, and accompanied by a certificate 
of identity in the case of persons attached to the sanitary 
service of armies who do not have military uniform. 

In the Regulations conceniing the American Red Cross 
Nursing Service, as adopted by the Executive Committee De- 
cember 20, 1012, which superseded the Circular of Informa- 
tion issued April 1, 1010, the following sentence was inoor- 



\ 





door aniform of an Amorican Rwl Ct^s nurse. Hub uniform was 
:>rri iltinii^; the Etiropeun War by all mtiuU-ra of tlic Army Nuriw 
vitL till- iimi^Miiu of tlidt CorpH. 



RELATION OF NURSING SERVICE TO THE ARMY 869 



porated into the section defining the Red Cross nurse's uniform: 
•'Nurses arc not at any time allowed to wear Red Cross bras- 
Bards without special authority from the American National 
Red Cross." 

The next mention of uniforms is to be found in the Arinutes 
of a meeting: of ttie National Committee on Red Cross Nursing 
Service, held December D, 11H8, at which 'it was decided to 
adopt a nurso*8 uniform for the Red Cross Nursing Service if 
a suitable material could be found. . . . Miss Delano was asked 
to get information about gray cotton crepe material, the cost, 
width, eta and to send this information to all Local Com- 
mittees." 

At a meeting held at the Planters' Hotel, St, Louis, Mo., 
on April 24, 1014, the National Committee again discussed 
the question of equipment and uniforms and "it was suggested 
that patterns be distributed by I-ocal Coiimiittces and that Local 
Committees be ready to help with details in any way in order 
to relieve the Washington oiHce. Samples of the uniform 
material were distributed, so that the nurses might begin their 
preparation. , . . The meeting was crowded with earnest, 
dignified, enthusiastic nurses ready to prepare for work which 
might oome." '-^^ When within four mouths, the first call for 
the mobilization of Red Cross nurses on a large scale soimded 
in the organization of the Men-y Ship Expedition of 11'14, the 
unifonn was thus practicuiUy atj^reed upijii. The nurses of the 
Mercy Ship, as it has been explained in Chapter IV, wore the 
gray cotton crepe uniform, with w^lutc collars and cuffs, a navy 
blue ulster and the Red Cross cap and cape. National Head- 
quarters allowed them to wear also the Red Cross brassard. 

In the meantime, certain small changes had occurred in the 
uniform of the Array NuTse Corps. In 1U13, the Surgeon 
Oeneral had authorized nurses on duty in the Philippines and' 
iu the Hawaiian Department to wear low collara. Tn 1913, 
he issued regulations changing the "waist and skirt" to a one- 
piece dress similar to that worn by Army nurses during the 
European War. When Army nurses were ordered with tho 
Punitive Expedition to Vera Cruz, Mexico, the question of 
laundry arose and Miss McTsaac, then superintendent of the 
Army Nurse Corps, decided that gray crepe uniforms would 
•olvc tlie problem. One of the nurses ordered there was Sayrea 
L Milliken, who later became assistant superintendent of the 

"MiDDtM of the National Committee, Vol. I, pp. 63-85. 



860 HISTORY OF AMERICAN RED CROSS NURSING 



Army Nurse Corps; she wrote, "I supplied myself at my own] 
expeuse with gray crepe uniforms, made exjietly like niir white 
ones, touched off by white collars, cuffs and aprons. This uni- 
form, however, was so unbecoming and washed so poorly thaij 
tlie nurses wore them^ only a few weeks and then, by special! 
permission from Miss Mclsaac, went back to the white uniform." 

As for the Red Cross nurses, the gray imiform for ward dutyj 
and the white uniform for dress wear, which were both worn 
with the Red Cross cape, remained the only distinctive uni- 
form of the Red Cross nurse until 1016, Then National Head- 
quarters undertook the orgauixation of base hospitals and othepj 
units for the Army and the question of unifonns arose again.] 
Miss Delano was strongly in favor of using the gray uniform,] 
because she thought it was highly practicable, but the Surgeon] 
Geuerars office did not share this opinion and Miss Delano 
was forced to coincide with their decision to continue the ustt 
of the white uniform, since nurses of base hospitals and othetj 
units, when turned over to the War Department, became mem-1 
beta of the Army Nurse C^orps and as such would be required^ 
to wear the uniform of that Corps. 

On June 2(1, lf*l7, Miss Delano telegraphed Miss Noyes,] 
then chief nurse of Base Hospital No. 1, that '*to save pur-j 
cliase of additional uniforms, it has been decided tbat membera 
of baae hospital units may wear the imiform of their schoolJ 
except caps. Brassards, capes and caps will be supplied with-^ 
out cost by the Red Cross upjn assignment to duty." Foi 
authorization of the change from the gray to the white unifoi 
was KHjuested bv Aliss Delano in a letter written July 17, 101' 
and addressed to General Afurray, then acting-chairman of th< 
Central Committee; this letter was returned approved by Gen-* 
eral Murray, Colonel Kcan and Mr. Bickneli under the same 
date 

While the American Nnrsea' Association was holding its 
Twentieth Annual Convention in Philadelphia, National Head- 
quarters wired Miss Noyos April 21», 1917, of the impending 
mobilization of six baae hospitals for service with the Britii 
Expeditionary Forces. Miss Noyes returned post-haste to Wash- 
iugtxm to look into tlic question of an outdoor uniform. The' 
Army had not standardized an outdoor uniform for its Nurse 
Corps, but the Surgeon Generars office concurre<l in the opinion 
of tile Red CroBs War Council tliat nurses of the units assigned 
to the British Expeditionary Forces should be distinctively 



RELATION OF NURSING SERVICE TO THE ARMY 361 



I 

I 



garbed as United States military personnel. Miss Noyes tele- 
crapbed Miss Van Blarc*oin, then the representative of the 
Nursing Service in the Atlantic Division headquarters, New 
York City, to call togetlier a committee composed of the chief 
nurses of base hospital units organized in the larger civilian 
boepitals of New York City, to consider the selection of a suit- 
able outd(X)r uniform. Miaa Maxwell, of the Presbyterian 
Hospital, and the other members of this group had sample 
garments and prices ready to submit to the cinimiittec by the 
lime Miss Noyes got over to New York. The committee selected 
an outdoor uniform consisting of a one-pieoo blue serge dress 
of distinctive military cut, a heavy blue nlster and a blue velour 
hat of campaign style and Miss Noyes immediately placed or- 
ders for a large number of these uniforms with a New York 
manufacturing clotbier. 

Base Hospital No. 4 (Lakeside) arrived at the port of em- 
barkation, however, before the uniforms were ready. The nurses 
of the unit sailed in civilian clothes, with only such accessories 
as capes, blankets, caps and other articles then in Red Cross 
supply rooms, but their measurements were taken so that the 
next unit scheduled to sail a few days later might take over 
their equipment. The Peter Bent Brighiun Unit (Base Hos- 
pital No. 5) also embarked withijut uuiforms. The third 
column to be ordered out was the Presbyterian Unit, and the 
nursing staff not only went completely uniformed but t»K)k with 
them equipment for the Lakeside and Peter Bent Brigham 
units. So hurried Jiad been the embarkation of these three 
pioneer columns that many of the nurses, especially those who 
lived at a considerable distance from New York City, went di- 
rectly from the trains to the docks and !Mias Noyes, ^[iss Van 
Blarcom, members of the New York (bounty Chapter and the 
tailors' assistants, followed them in taxis and private limousines 
piled high with boxes of dresses, hats and other articles. 

The New York Count}' Chapter, which had equipped the 
nurses of the Mercy Ship, acted as agents for National Head- 
quarters. Mrs. John 8, Thatcher, Prances Anderson and Mary 
Mugoun Brown volunteered their services. The Chapter as- 
sumed the immediate responsibility for the payment of the 
clothiers' bills until National Headquarters could secure a de- 
cision from the War Department that the Government would 
furnish nurses* equipment, or until the Bed Cross War Council 

lid appropriate funds for this purpose. 



86« HISTORY OF AMERICAN RED CROSS NURSINl 

Miss ^oyes notified the mannfacturitig tailor on June 1; 
1917, to prepare to equip Base Hospital No. 17^ of Detroit, and 
four additional Army base hospitals. Her letter also gave an 
important change in procednre; Miss Thompson had eonaented 
to issue nuraes' sailing orders several days in advance so that 
the nurses might have opportunity to be measured and fitted 
for uniforms after their arrival in New York. This was a 
great advantage over the former system by which the chief 
nurse had endeavored to secure and forward the nurses* rncixs- 
ureraeuta to the manufacturing tailor before the unit had left 
its home city. 

The Minutes of the National Committee on Red Cross Nurs- 
ing iSorvioe, which met Juno 16 at National Headquarters, 
recorded this action; 

The chairman stated that in order to equip Red Cross 
nurses assif;ned to 4lnty as expeditiously as possible, it was 
neccK.Hary to appoint a special committee on uniforms, who 
would be rcsixinsible for selecting the uniform and issuing 
the cqiiijuueut. As the time was liniitetl, the chairman 
appointed this committee as follows: Mrs. John S. Thatcher, 
chairman; Miss Charlotte Stillman; Miss Frances Anderson; 
Miss Anna C Maxwell; Miss Mary M. Brown. 

The chairman asked tliat this action l>e ratitied, as this 
Committee should he n|i]>ointed by the National Committee 
ratlicr than by the chairman. [Motion to this effect made 
and carried.] 

Mrs. Thatcher immediatel}' began to look about for a suitable 
place in which to establish headquarters for the e(]uipmcnt di- 
vision. She visited the newlyH*stahliahed headquarters of the 
Atlantic Division, then located at No. One, Madison Avenue, 
and conferred with Miss Van Blarcom, who us the representa- 
tive of the Nursing Service in the Atlantic Division was an ex- 
officio member of the Counnittee on Equipment, It was then 
decided to locate the equipment work there. Miss Van Blarcom 
at the same time secured the services of Maude G. Moody to 
assist Mrs. Thatcher in the business details of the w*ork. "Afrs. 
Moody has l»een recommended to us," wrote ilrs. Thatcher to 
Miss Noyes tm June 14, "as an unusually capable woman, of 
good executive mind, tactful and of pleasing personality.'^ 

Mrs. Moody wi^ite of the expansion of the early division of 
nurses^ equipment: 



RELATION OF NURSING SERVICE TO THE ARMY 3G3 



F 



In June, 1917, the Atlantic Division took offices on the 
thirty-second floor of the Metropolitan Tower, aud the Bureau 
of Nurses* Equipment wae soon in actual operation there. On 
the twenty-eighth floor we had a little storeroom where our 
stock of all articles, excepting the ulsters and dresses, was 
kept. We carried tan gloves, aprons, etc., for the nurses to 
purchase at cofit. 

Array Base Hospital No, 15 (Roosevelt Hospital) was the 
first licit equipped by the bureau. As we had no assembly 
room to whicli the nurses could come, we conveyed the equip- 
ment to them at the hospital. To transport those nmii\ 
packages, Mr. John Nieser of the Manhattan Storage and 
VVarehouse Company offered us the use of his vans. Ellis 
Island in the meantime had been designated as the nurses' 
mobilization station, and it was not unusual to sec the vans 
backing up at the ferry-house discharging their cargo of 
hundreds of boxes of all sizes, to be transferred to the waiting 
baggage trucks which husky corpsnien hustled aboard the 
ferry. Perilous indeed were those trips from Island Xo, One 
to Island Xo. Three, when we dashed from one truck to 
another trying to keep that precious equipment from falling 
under the wheels! Once safe in the large many-windowed 
assembly room of Island Xo. Threi*. the hold-idls aiul boxes 
were arranged alphabetirally and given out to the long line of 
waiting nurses, who signed their cards, had their hats fitted 
and went off laden with burdens almost too great to carry. 

Following the establishment of the Bureau of Nurses' Equip- 
ment ut Atlantic Division headquarters, the next step in buihl- 
ing up efficient organization was the transfer of all responsibility 
for o<|uipping nurses irom the New York County Chapter to 
Division and National Headquarters. Mr. Leo Arustein was 
then Director of Military Relief of the New York County 
Chapter and he was loath to surrender responsibility which he 
fell tielonged in his department. Miss Noycs announced this 
transfer in a letter written June 15 to Mr. Harvey D. Gibson, 
then chairman of the Executive Committee of the New York 
County Chapter. "This arrangement,'* commented Miss Noycs, 
"will centralize all nursing affairs at a given point, an arrange- 
ment never before possible owing to the fact that we have not 
bad a direct representative in New York until Miss Van Blar- 
CDzn's aasignment there. I cannot begin to tell you," she con- 
cluded, ''how fateful we are to the Chapter fur the services 
«bicb they have rendered in the past. We must have been a 
very great trial at times." 



364 HISTORY OF AMERICAN RED CROSS NURSING 



The cost of equipping theao first units of nurses was increas- 
jng by leaps nnd liouiids and National Headquarters had already 
foreseen that liiianeial responsibility for this work would far 
exceed tlie rrsourees of the New York County Chapter and 
would 8(x>n bepome a matter for decision between the War De- 
partment and National Headquarters, Miss Noyes submitted 
a memorandum to the War C^tuncil in July, 1917, which recom- 
mended outdoor uniforms for nurses at an estimated cost of 
$35,580 per ihuusand nurses. "'The War Cotineih" stated 
the minute covering a meeting of the War Council held July 4, 
1917, "decided to refer the matter to Colonel Kean, with in- 
structions to present it formally to the War Department, As 
the nurses, on going into service, come immediately under the 
War Department, it would seem that the War DepartmeDi 
should decide upon the uniform and pay for same." 

At a meeting held July 10, Mr. Wadsworth again brought 
up the question of nurses' equipment, Mr. Davison stated that 
it was the policy of the War Council that Red Cross nurses 
assigned to service in Allied countries should always be uni- 
formed. The War Council accordingly voted that the "Chapters 
sending Tied Cross units shall provide uniforms for nurses, 
that nurses whom Chapters are unable to uniform shall be 
.uniformed by National Headquarters, and Mr. Wadsworth is 
directed to make arrangements accordingly with eacli Chapter." 

Early in July, Colonel Kean was placed in charge nf the 
Ambulaiu-e Service of the American Kxpcditifuiary Forces 
and was sent immediately to France. John D. Ryan, of New 
York City, was elected Director General of Military Relict 
Colonel Winford Smith, late superintendent of Johns Hopkins 
Hospital, was detailed on July 18, 1017, to represent the Sur- 
geon General at National Headquarters and on August 31, 
he was elected I>irector General of Military Relief, following 
the appointment of Mr. Ryan to membership on the War 
Council. 

While the War Department, National Red Cross Headquar- 
ters and 1>ochI Red Cross (.^japters were considering who should 
pay the bills for nurses* equipment, the fortunes of war took a 
hand in tbe matter. The S, S. S^nnitoga , on which Base Hos- 
pital No. H had embarked for France, ciillided on July 30 in 
New York Ilarlwr with tbe Cify of Panama, The nurses had 
gone to their staterooms, had remo\-ed their heavy uniforms on 
acoount of the intense heat and in kimonos and night gowns 



RELATION OF NURSING SERVICE TO THE ARMY 365 



were resting or sleeping. Following the wllision, all hands 
were ordered immediately to the life-hoats. The nurses caught 
up capes and coats, flung them over their scant garnieuU and, 
with admirable savoir faire, tt>ok their places in the boats, ubun- 
doning not only their uniforms but other articles of clothing 
and their money as well. 

The Sarafoya sank eighteen minutes after she had been struck. 
The life-boats containing the nurses were rowed some distance 
from the accident and held there for further orders. The men 
of the rescuing crews spread their coats over the shoulders 
of the nurses to protect them from the glare of the July sun. 
After a tedious delay, the nurses were rowed to Ellis Island. 
The interned Germans and agents detained on the Island 
crowded to the wire fences to watch the American women come 
ashore. Wet and insufficiently clad, with their arras and faces 
burned and their nerves taut from a harrowing experience, 
the nurses, when they heard the jeering words of the enemy, 
conducted themselves^ according to the best traditions of Ameri- 
can womanhood. Up went their heads and they marched 
proudly to their dormitories with laughter on their lips. 

On August 1, Miss Van Blarcom telephoned Miss Xoyes 
that the nurses of the unit were stationed on Elli.s Island with- 
out adequate clothing. Miss No^'cs went immediately to the 
offices of the War Council ; the meml>er8 were holding one of 
their customary morning meetings. Miss Noyes presented 
the facts of the case and asked the War Council to appropriate 
funds sufficient to rcequip the nurses, — an appropriation which 
estimated roughly at $14,000 or $200 per nurse. A 

!mber of the War Council siiggested that Miss Noyes call 
the War Department to ascertain w^iether any Government fund 
was available for such purposes. 

Misa Noyes was referred to Colonel Birmingham, then 
Acting Surgeon General of the Army. He stated that the 
only possible way in which the War Department could reequip 
these nurses was by special Act of Congress! 

Miss Noyes again went to the War Council and within two 
bonrs after the time when Miss Van Blarcom had first tele- 
phoned, National Headquarters had appropriated $14,000 
for the complete nHMjuipnient of the destitute nurses at Ellis 
laland and Miss Noyes had instructed Miss Van Blarcom by 
telephone to begin the selection and purchase of the various 
articles. 



3G6 HISTORY OF AMERICAN RED CROSS MJRSING 

Wlien the nursing representatives of the Atlantic Division 
went over to Ellis Island to confer with the nurses regarding 
tlioir needs, thej found a chaotic condition. Mrs. Moody de- 
scribed it; 

Ellis Island showed us "stay-at-homes" to a small degree at 
least what war meant. Island No. 3 looked like o refugee 
camp in a war-ridden country. Spread over the lawn were 
water-soaked army lockers, stained and muddy clothing, here 
a white uniform streaked with the red of a cape which had 
lain near it, there a pathetic-looking shoe ruined beyond re- 
pair. Too much cannot ho said in praise of the courage 
displayed by these women who after a harrowing ordeal during 
those torrid summer days met us with a joke and a smile. 

In the meant imCj the six American base hospitals assigned 
to the British Expeditionary Forces had arrived in France. 
None of the British General Hospitals where th(?y were detailed 
for duty were equipped witli laundries and the nurses soon 
discovered that they would have to wash out the white uui- 
forms after they came off duty if they were to present a neat 
and professional appearance. MemlK'rs of several base hos- 
pital units even joincc^ groups of French women who were 
pounding their clothes clean in convenient brooks! "The white 
uniform ia most unpractically" wrote iXIiss Stimson at Rouen, 
France, to Miss Noyes. "The night nurses put them on with 
aprons and caps, then don raincoats and rubbers^ carry an 
umbrella in one hand and a lantern in the other and start on 
their rounds from one tent or hut to another. By morning 
you should see the caps of those who have not brought rubber 
hats, after they have ducked in and out of the tents, and their 
white skills, after they have gone splashing through the sticky 
yellow mud!" 

Dr. Richard H. Harte, director of Base Hosy)ital No. 10, 
which was stationed with the British at fttretat, stated in a 
letter written to Aliss Delano on .huie 17 that in addition to 
the impracticality of the white uniform, the nurses' equipment 
was sadly inadequate. "Each nurse,'- he declared, "should have 
a good pair of rubber boots, a mackintosh, and a rubber hat, 
preferably the ordinary sou'wester worn by sailors. Anything 
less will be bh)wu o(f by the terrific winds prevailing here. 
It is also terrifically cold." 

Colonel liobcrt E. Koblc transmitted August to the Di- 



RELATION OF NURSING SERVICE TO THE ARMY 307 



rector General of Military Relief a copy of the following regu- 
lation : 

Referring to information received in this office that the 
white uniform now used by members of the Army Nurse 
Corps is not practicable for service iu Europe, 1 am directed 
by the Surgeon General to inform you that the use of a 
medium gray uniform and white npron luis been nutliorizcd to 
be made in accordance with 8[)ecificntiong enclosed herewith. 
This information Ik furnished so that reserve nurses going to 
Europe may have their unifomia made to conform with these 
instructions. This authority has l>ecn forwarded this date to 
the commanding officers of the United States Army hospitals 
now in Europe. 

A certain amount of well-behaved hunu>r appeared in the Min- 
utes of the War Council f(»r August 8, 1917: 

The chairman stated that iu preparing IJed Cross base 
hospitals for service abroad, the white uniform for nurses was 
inBisted upon by the Medical Department of the Army; that it 
now appeared that owing to lack of laundry facilities, white 
uniforms are impracticable iu France and the Surgeon Gen- 
eral's oHice has (iccided to adopt tlie gray uniform ; that there 
are sixty-five nuryes in each of tJie six base hospitals with the 
British forces in France, all eqiiipped witli white uniforms 
purchased at the expense of the individual nurses, the same 
being true of the nurses in the six hospitals with the American 
troops in France; and that no dou))t many nurses of the 
hospitals not yet called have supplied themselves with the 
white uniforms formerly required. 

The chairman further stated that these nurses could not hc 
expected to go to additional expen&c in buying more uniforms ; 
that thp estimated cost of the gray uniform hein^ about $1() 
it would require about $1040 to equip the sixty-five nurses 
of each unit; and on the recommenHation of the Department 
of Military Relief, he advised tins appropriation. Whereupon 
it was, on motion 

Voted: That from the Red Cross War Fund the sum of 
$14,000 be and is hereby appropriated for furnishing pray 
uniforms to the nurses of the twelve base hospitals serving 
with the British and American troops in France. 

Miss Noyos then set nh<:>ut furnishing the gray dress to nil 
nnrsea of base hospitals and other units, both in this country 
and overseas, through the New York Bureau of Nurses' Kquip- 
mait and through the office located in Paris of the chief nurse, 




368 HISTORY OF AMERICAN RED CROSS NURSING 

American Red Cross in France. The difficulties of sending 
the gray uniform to all members of base hospital units then 
with the British and American Expeditionary Forces was 
greatly heightened by fiiibmarine warfare. Twice the enemy 
Slink merchant steamers in wlxicli gray imiforms had been sent. 
The following quaint <lescTiption of the Scsura Amerlcaines, 
appearing in a French newspaper, recorded their final meta- 
morphosis : ^m 

The American nurses, noires dames grimes, we see leavin^^ 
the hotel where they are lodged and note tlmt almost every one 
.is trtll luirl stately in stature, wearing short gray skirts and 
lacoiJ brown boots. The waist has a largo white collar and the 
white apron is worn in a crosswise fashion in the back. The 
head is coquettishiy crowned with a little white cap, which 
rests softly on the knot of hair, dresi^d in a style much like 
the arrangement used by our own women. Many of them 
wear large round eye-glasses, which make them retain their 
youthful appearance and look as if they were school girls 
going to their class. 

The question of tKe insignia to be worn by reserve members 
of the Army Nurse Corps, the cause of patient and prolonged 
discussion between the Surgeon GeueraTs office and the Red 
Cross, had first arisen in August, 11)10, following the assign- 
ment of Red Cross nurses to United States base hospitals on 
the Mexican border. One year later, on August 27, 1917, the 
War Department made its iirst move toward the militarization 
of Red Cross nurses; Acting SurgtH>n General Birmingham 
then wrote to the Director General of Military Relief: 

In reply to your letter of August 18, relative to the wearing 
of the brassard i)y the reserve nurses, Army Nurse Corps, 
unless the use of the brassard by members of the regula 
Military Establishment is indicated, its use by members of 
Beserve is not considered necessary. Also, the wisilom 
weanng the brassard in Europe has been questioned on 
count of its conspicnouBness. 

It is requested that hereafter the outdoor uniform of 
reserve nurses, which is furnished by the Ked Cross, be made 
to conform in all respects to that which has lx»en approved by 
the Secretary of War for the Army Nurse Corps (diagrani and 
infonnBti<»n enclosed). Owin^r to the confusion wliieh has 
been created in the minds of the nurses by the use of the 
Bed Cross on the cap and cape, the authority given in let 




RELATION OF NURSING SERVICE TO THE ARMY 369 

from this office dated Atigugt IS. 1916, for the use of this 
emblem on these articles is herebj' revoked. 



I 



I 



With this letter, flpecificationa were sent for an outdoor uni- 
form^ Army Xurse Corps, consisting of blue serge norfolk coat 
and skirt. This uniform replaced the Red Cross serge dress 
and was to be worn by all Army nurses in foreign service. At 
the same time, the Surg(Nm Generars office adopted a new 
white uniform of diatiactive type, to be worn by nurses while 
on indoor duty in military hospitals in the United States and 
wherever pruclieablc in foreign service ; the use of the gray 
uniform was retained, however, for general ward duty over- 
seas. 

For nurses volnntccring for foreign service, this ruling made 
necessary the purchase of entirely new indoor and outdoor 
tmiforma. For the Red Cross Nursing Service, these regula- 
tions meant the banishment of the cap and cape, beloved symbols 
of an ideal of pure altruism. Following protracted conferences 
between the Red Cross and the Surgeon Generara office, Colonel 
Birmingham wrote September 11, 1917, to the Director General 
of Military Relief: "Referring to letter from this office dated 
August 27, relative to the uniform of the reserve nurses. Army 
Nurse Corps, upon further consideration the use of the Red 
Cross cap is hereby authorized. The nurses may also continue 
to use the present cape, but without the Red Cross upon it" 

Banishment of the well-loved Red Cross badge was con- 
firmed on October 10, 1017, in a letter addressed by Miss 
Thompson to Miss Delano: "In regard to the ruling of the Red 
Cross piu, it was decided some time ago that the Hed Cross 
on tlie cap was to be used to indicate that the wearer was an 
enrolled Red Cross nurse and that the piu was not to be worn 
with the uniforms." 

Following the atithorization of the new indoor and outdoor 
tmiform for members of the Army Nurse Corps assigned to 
foreign service, the Red Cross felt even more strongly than 
they had at the time of the embarkation of the Red Cross base 
hospitals, that the Government should fiimiah uniforms and 
eqaipDient for nurses assigned to military service. The Di- 
rector General of Military Relief brought this question to the 
attention of the Surgeon General on August 30 ; he in turn re- 
ferred it to the Secretary of Wnr, but Mr. Baker did not share 
the opinion of the Red Cross. Colonel George E. BushnelU 



370 HISTORY OF AMERICAN RED CROSS NITRSIXl 



Acting Surgeon General, Medical Corps, wrote on September 
20, 1917, to the Director General of Military Relief, National 
Headquarters: 



Relative to the Hothiiijf allowance for nurses ordered t 
Europe, this question was taken up.with the Secretary of War 
and a letter sent from this otfice recommending an appropri 
Uon be nmile for this [turpoee. 

The rocommendatiun was returned disapproved, with t 
remark that it was not the policy of the War Department 
make clothing allowance during M'ar. 

In view of the expense of this equipment, which in the 
opinion of this office is too heavy to he borne by the indi- 
vidual nurse, it is requested that the War Council of the 
American Red Cross make some provision for the nurses 
ordered to Europe. 

It is also requested that the allowance be made to members 
of the permament Corps as well as to the re8er\'e nurses who 
may he ordered abroad for duty. 

The War Council was at this time considering the equipment 
and uuifonns of members of the Red Cross foreign commissions. 
On Soptcnd)or 20 thcv hud appropriated an allowance not to 
exceed two hundred dollars ($2001 for each memher of such 
units. Following the receipt of Colonel Bnshncirs letter, they 
authorized the Nursing Service to recommend a list of equip- 
ment nect^flsary for all nurses assigned to foreign service. 
Chosen with care and econ(»my as Ix'titted the expenditure of 
Red Cniss fiinds, yet with full Insight t*i fnturtf needs, and 
given with the same g(»nenj8ity of spirit which had led Miss 
Delano to buy and pack l>oxes of cunifttrt for her "lambs" of 
the Mercy Ship, tlie list of articles as finally worked out by 
Miss Noyes comprised: hat; outdoor uniform; «)at or hea\^ 
ulster; nape; gloves; shirtwaists, two, white; shirtwaists, eohinni 
flannel (two if suit is us(»d) ; gray wash uniforms, four; aprons, 
six or eight; cTiffs and collars, six sets; caps; sleeve links, 2 
pairs; caduceii, one set; U. S. letters, one set; black woolen 
tights, 2 pairs; steamer blanket, one; sleeping Img, one; swenter, 
gray, one; p*>ncho, or nibber sheet, one; blanket roll, one; rain- 
coat, one; rain hat, one; rubber boots, one pair; moccasins, one 
pair; shoes *^; stockings"; heavy underwear-^; pajamas." 

■Siiwu. nttkckingK. hcnvy iinflerwpar Qm) pnjaniHH wore nnt in the fli 
li«t of *M|tiipnipnt fiirniftliod by tlio Red Crofts without cost. These nrlicl 
bttd to lie supplittl by tht? nurgea theniBcIveB (A. K. C. 7<»2, DfcoTnb«?r 
1017). Lnt<>r, howeviT, thfy were nU addtnl (Septc-niber 18. 1918). 



P 



»& 




RELATION OF NURSING SERVICE TO THE ARMY 371 



I 



I 



The Bureau of Equipment, at the Atluntu* Division now set- 
tled down to the long pull ahead. Mrs. Thatcher had resigned in 
September, 1917, the chainnansliip nf the Uniform (\)mmittee. 
The etiicieney of tJie orgatiiznfion of the Imreaii ^uuh^r Mis-s 
Van Blarcom and Mrs. Moody had relieved Mrs. Thatcher and 
Miss Brown, the two most active mombers of the committee, 
of the heavj* responsibilities which they had bravely borne 
since May, 11*17. Mrs. Thatcher wished to turn her enthu- 
siasm and energy to more active expression than the chairman- 
ship of an Advisory Committee on Uniforms permitted. Xursea 
will long remember with gratitude, however, her courteous, 
faithful assistance during the strenuous spring and summer 
when the base hospitals were embarking for France, 

Miss Xoyes wrote on October 16 to Mr. Harvey D. Gibson, 
by this time general manager at National Headquarters of 
the Red Cross/-" requesting the first of the several extensive 
appropriations made from time to time by the War Couucil 
to sustain the Bureau of Equipment: ^'I should bo grateful," 
she stated, "if the War Council would vote an appropriation 
sufficiently large to enable us to carry an adequak* supply in 
our store-room, viz., five hundred sets at two hundred dollars a 
set. We tind it exceedingly difficult to secure sleeping bags, 
steamer rugs, rubber boots and slickers on short notice. We 
now have four units waiting in New York for sleeping bags. 
All their other equipment was given by Local Chapters before 
they left home. To avoid such situations as this, it seems highly 
important that an adequate supply be kept on hand." The War 
Council appropriated on October 30, 1917, one hundred thou- 
sand dollars **for the purchase of equipment for Army and Navy 
nurses, it being understood that in the case of hospital units, 
etc., which would ordinarily be outfitted by Chapters, the amount 
90 spent shall be collected from the Chapter wherever possible." 
This attempt to have the local Chapter include nurses' equip- 
ment in its appropriation for base hospitals was never satis- 
factorily worked out and was later completely given up. 

In order that Red Cross public health nurses working in the 
sanitary zones which the United States Public Health Ser\*ice 
had drawn about the cantonments, might be properly uniformed, 



"The office r>f General Mnnnger, Nntional HeHdquarters, American Red 
Croa*. waa created by the War (lounril on July 11, 1017. and Mr. Harvty 
D, Qibacra, late cliuirman of the Executive Comniittce of the New York 
County Chapter, waa apjMiintctl to the poaition. 



372 HISTORY OF AMERICAN RED CROSS NURSING^ 

the War Coaincil also appropriated funds to furnish uniforms 
and equipment to them. The following statement appears in 
the pamphlet, Information for I^urses Called Upou for Active 
Service (A. 11. C. 702, December 31, I'JIT ) : 

Nurses assigned to sanitary zones under the Red Cross for 
public health or other forms of service will be provided, free 
of cost, with the following articles: one or more outdoor uni- 
forms of dark blue serge; detached waist with high collar; one 
blue ulster; one ca|>e, dark blue, lined with red, insignia on 
left side; one hat, dark blue velour; caps; three gray uniforms. 
These articles will be issued upon the arrival of the nurse at 
her destination. 

When the Army was mobilizing its Psychiatric and Ortho- 
pedic Base Hospital Units, ^'o. 117 and No. 114, Jliss Thomp- 
son in a letter addressed on March 4, 1918, to Miss Delano, 
asked if the Red Cross would supply equipment to the civilian 
employees and the reconstruction aides of these units. National 
Headquarters ultimately shouldered the responsibility for equip- 
ping, through the Bureau of Nurses' lujuipmeut in New York 
City, all nurses, dietitians, clerical workers and aides for all 
types of foreign service in the Army, the Navy and America^H 
Red Cross commissions. ^g 

On January 15, 1918, Caroline Van Blarcom, who had rep- 
resented the Nursing Service at the Atlantic Division since the 
early summer of 1917, resigned and Flon^nce Merriam Johnson 
was appointed tia director of the Department of Nursing there. 
The Bureau of Nurses' Equipment was maintained as a branch 
office of National Headquarters, but Miss Johnson, representing 
Miss Delano and Miss Noyes, had general supervision of its 
activities. 

Now in March, 1918, be-gan that long procession of women, 
which day after day passed in ever-increasing numbers through 
the port of embarkation for Europe. Mrs. Moody described 
the expansion that had been going on of the Bureau of Equip- 
ment; 

In October, 1917, the Atlantic Division moved across the 
street from its former home and our new storeroom seemed 
enormous. Only too soon did we outgrow it and packing cases 
lined the corridors. The overseas units began mobilizing 
thick and fast and we found it necessary to secure more 




RELATION OF NURSING SERVICE TO THE ARMY 373 

trucks. The Peter Doelger Brewing Company came to our 
rescue and many were the smiles of amusement from by- 
standers when those bright yellow brewery wagona would 
begin to disgorge their Red Cross Iwxes. 

It became necessary now to revise our previons method of 
issuing equipment, botl) hev-aiise of the many articles and also 
because of the great numbers of personnel sailing each week. 

When a b&av! hospital or unit arrived in New York, Miss 
Johnson appointed a day wiien that group should report to 
her at the Atlantic Division headquarters. After her graphic 
and inspiring talk, the nurses came to the Bureau of Nurses' 
Equipment (we had moved to the New York Branch of 
National Hendquurtprs at 222 Fourth Avenue and now had 
half an office floor, none too much space). Here cards were 
distributed to each nurse. On these cards were listed all the 
articles to bo issued and the nurse, after filling in her name, 
unit and badge number, designatetl on the card the sizes of tlie 
garments which she needed. Perhaps here she first appreci- 
ated the hardships of war. She was destined to have her 
uniform hats tried on without being allowed even a peep at a 
mirror. 

To every member of the. group we gave an order for shoes 
and rubber boots and the next day tlie unit went en masse to 
the one tailor to be fitted for suits and coats, then to the other 
for gray service uniforms and raincoats and then on to the 
shoe-shop. WJien the necessary alterations had been com- 
plete*], these boxes were picked up by our truck. It next 
rolleoted holdalls, carefully packed at the Bureau of Equip- 
ment. These holdalis containing the rest of the nurse's 
articles, were tagged with her name. By this system botli 
iKixes and holdalls were delivered to t-Iie various hotels where 
nurses were staying. 

So crowded did our quarters become that we found it neces- 
sary to haye the units a^^semble for equipment at various halls 
loaned to us by ditTerent organizations in the vicinity of 
Madison Square. In tlie meantime, our stock had increased to 
carry numberless articles not im'luded in the equipment 
issued, but which the nurses needed and which we sold to 
them at cost. AH tliroujj^h that summer of 11)18, the line of 
nurses waiting outside the Bureau of Equipment seemed end- 
less, stretching from the elevators down the long hall to the 
counter of the storeroom, nurses, dozens, hundreds of them, 
dietitians, secretaries, reconstruction aides and other workers 
sent us by the Red Cross Bureau of Personnel. One of our 
workers^ Mary M. Brown, established a charming custom of 
Bending a box of flowers to each unit, so that every worker 



374 HISTORY OF AMERICAN RED CROSS NURSING 



going overseas could have at least one bloesum as a tiny per- 
sonal message, a word of greeting and a Godspeed. 

For utirses serving directly under Rod Cross commissions 
to the Allied Powers, Miss Delano and Miss Noye-s had adopted 
tlic same uniform as that of the Army and Navy Nurse Corps. 
Of the equipment of these nurses, Mrs. Moody wrote: 

Before they reported to the bureau for equipment, Miss 
JohuBou saw individually every nurge filing under the Red 
Cross flag. How interesting it all was for us when a unit was 
being sent to so romantic a country us Paleatine or Porto 
Rico and how eagerly we revised and planned their equipment 
to meet these particular services ! 

A nurse on active duty with Red Cross foreign commissions 
wore upon her hat band, upon her shoulders and upon the lapels 
of her coat, the s^-mbol of the organization. Without consulta- 
tion with the Army Nurse Corps or with National Headquar- 
ters, the Red Cross Commission for France adopted in 1918, 
upon the authority of the Chief Surgeon, American Expedition- 
ary For<;es, a distinctive emblem made by placing an enameled 
Red Cross upon the caducous of the Medical Corps. The bronze 
letters "U. S." were worn with this device and insured for the 
wearer recognition and protection in the foreign theaters of 
war where the American Armies were operating. 

Previous to August, 1918, nurses 8t!rving in Array hospitals 
in the United States had been permitted to wear the uniform 
of their schixil, provided it was not extrejne in cut, when on 
duty, but when olT duty, they had worn civilian clotlies. Fol- 
lowing an increase of salary for the members of the Army and 
Navy Nurse Corps from tifly dollars ($5U) to sixty dollars 
($60) a month for domestic service and from sixty dollars 
($fiO) to seventy dollars ($70) for overseas duty, the Surgeon 
General authorized that all members of the Army Nurse 
Corps should wear the outdtwr uniform. On Jnly 23, 1018, 
Colonel Winford H. Smith transmitted to the general manager 
of the American K<*d Cross, for the attention of the Nursing 
Bervioe, the following regulations issued by the Surgeon 
•General, regarding uniforms: 

Nurses who enter the service at this time are permitted to 
wear such white uniforms as tliey may have, provided that 
they are not eatreme in any way. When it is necessary to 



I 
I 



I 



I 




RELATION OF NURSING SERVICE TO THE ARMY 375 



replace these uniforms, they must then be obtained in accord- 
ance with Bpeeifications. with this exception : The uniforms of 
all reserve nurses must conform in all respects to that of the 
Army Nurse Corps. 

The use of the outdoor uniform is considered advisable and 

it is further directed that all members of the Army Nurse 

Corps, including^ the reserve nurses, purclmse the suit, hat 

id necessary waists within three months after they enter the 

'ice. This uniform will be worn at all times when not on 

[uty. 

The overcoat 8hould be purchased if and when the weather 
requires its use. 

On August 15, 1918, the following ruling was sent by the 
Surgeon General of the Army to the commanding otiicers of 
oil military hospitals in the United States; 

1. I am directed by the Surgeon General to inclose here- 
with specifications, cap pattern aud other data concerning the 
indoor and outdoor uniform of the Army Nurse Corps. Nurses 
who enter the service at this time may be permitted to wear 
such white uniforms as they may have, for a period of six 
months after their entry into the service, provided tficy are 
not extreme in any way. When it is necessary to replace these 
uniforms, those made according to specifications must then be 
obtained. With this exception, the uniforms of all nurses, 
includiti'g the cap, must conform in all respects to that of the 
Army Nurse Corps. 

As the use of the outdoor uniform is considered advisable at 
this time, it is further directed that all members of the Army 
Nurse Corps now in the sen'ice, purchase the suit, hat and 
necessary waists within three months, and all those who enter 
the service hereafter purchase these garments within three 
mouths after their entry into the service. Before ordering 
the^e garments, however, those nurses who are physically or 
otherwise unfit for the service should be informed to that 
effect in order to avoid placing them under any unnecessary 
exjiense in the purchase of these garments. This uniform is to 
be worn at all times when not on duty in the hospital. The 
overcoat should be purchased if the weather requires its use. 

2. The American Red Cross will omit from the equipment 
of nurses ordered overseas the above mentioned articles, but 
will continue to issue to these nurses exceptional equipment. 
Four months, however, will be allowt?(l for adjustment. The 
Red Cross has also signified its willingness to issue to all 
members of the Army Nurse Corps on duty at home or abroad 




376 HISTORY OF AMERICAN RED CROSS NURSING 




a dark blue cape lined with red, the use of which is hereby 
authorized. Ttie insignia of thp Army Nurse Corps and the 
letters *'![. S/" may be worn on the collar of the cape. Tlie 
chief nurse should notify the director of Nursing Service. 
Atlantic Division, 44 East 2'Sf\ Street, New York, in regar(l 
to the number of capes needed by the nurses at tlie hospital 
from time to time, giving their names. If sweaters are re- 
quired for additional warmth, gray ones should be obtained. 

Several months before, when the question of the Red Cross 
cape had been under lively discussionj the Surgeon GeneraVs 
office had contended that this garment when worn by reserve 
nurses of the Army Nurse Corps tended to ditferentiate them 
from the Regulars and thus to break down the esprit de corps 
of that body. When National Headquarters offered to furnish 
the cape, without the Red Cross upon tlie left side, to all 
members of the Army Nurse Corps, its offer was immediately 
accepted and the traditional blue garment with its scarlet lining 
was issued to all nurses assigned to foreign and home service. 

The ruling of August 15, 191S, which removed the Red Cross 
from the reaer\'e nurse's cap, was made in the interest of dis- 
cipline, but evoked regret among the nurses. The following 
letter is typical of many received at Red Cross Headquarters: 

I ara so glad we are to wear outdoor uniforms. We've 
always hoped that it would be so, but we who canae into the 
service through the Hed CroPs are disappointtnl and hurt to be 
deprived of all possible sign of the fact. It is not that we 
have any objection to the new cap ; it is nice and neither gives 
nor takes anything from us aa nurses. It is Himply that we 
loved to be known as Ked Cross nurses. We volunteered for 
that organization and would have liked to retain something to 
show our association with it. 

A question of inteniational Red Cross policy presented itaelf 
in reference to the habit and insignia of Catholic Sisterhoods. 
One of the specific duties of the National and Local Committees 
on Red Cross Nursing Service, was "to keep on file lists of 
Sisterhoods and other orders and women volunteers, available 
for Red Cross relief work involving the care of the sick and 
wounded, either in time of war or calamity," 

During the summer of 1018, the Red Cross was especially 
anxious to utilize the services of Sisters of Charitv, who had 
alwi^s held an honored place in military nursing. They, too, 



4 

4 



4 
4 



RELATION OF NURSING SERVICE TO THE ARMY 377 

earnestly desired to serve. Miss Delano wrote on June 10 to 
Miss Thompson stating that some time before, she had secured 
a list of the Catholic Sisterhoods in the United States, but 
had never written to them asking for the probable number 
available for service in time of need, "I shall be very glad," 
concluded Misa Delano, ''if you will toll me if you tliink it 
desirable for me to send out a letter requesting this iuforma- 
ticm." Misa Thompson replied on Jime 18: 



Relative to the use of Roman Catholic Sisters in Army hos- 
pitals, I have referre<l thi?' matter to Colonel Smith of the 
Hospital Division M'ith tho rosuit it is holieved advisahle to 
plaoe on file the resources of tlie SisterhotuTs of the countrj*, 
pTOviflod they are graduate nurses and eligible for enrollment. 
Should it he necessary to use these Sisters, your office mil be 
80 informed at once. 

It is believed there might be some trouble in regard to 
accommodations for the Sisters. Many of the nurses are 
obliged to live in dormitories. Furthermore, in many hospi- 
tals, the nurses are obliged to wear a large white apron over 
their uniform, as well as a mask over their faces. This would 
be difficult for the Sisters. They are obliged in all cases, I 
understand, to wear the habit of their order. 



After some slight misunderstanding, Colonel Smith wrote on 
July 3, 1918, to Misa Delano that "indeed there is every reason 
why enrollment should be made of all such nursing Sisters 
who are graduate nurses. It should be understood, however,*' 
he added, "that if ordered to active duty, they will come in on 
exactly the same terms and under the same regulations as to 
conduct, uniform regulations, etc., as all other members of the 
Army Nurse Corps." 

The matter stotxl thus until the mobilization of Base Hos- 
pital No. 102 which lu»d am*>ng its nurses ten Daughters of 
Charity. A special ruling was then made which permitted these 
Sisters to wear the garb of their order but the Surgeon Gen- 
enira office again stated that if members of the Oatholic Sister- 
hoods were assigned in the future to the Army Nursp Corps, it 
would be with the understanding that they wear the regulation 
uniform of tiiat Corps. -^ 

This decision promised to inundate Red Cross Headquarters 

■8m inter-office 1ett«r written July 0, 1918. by Miea Delano to Mias 
Kerr, director of the Bureau of Enrollment. 



378 HISTORY OF AMERICAN RED CROSS NURSIVG 

with criticism from the Catholic Press similar to that of 1917^" 
before Sisterhoods clearly understood that the Surgeon Gen- 
eral's office and not the Red Cross Nursing Service was debar- 
ring them from active duty. Colonel Smith, however, wrote 
Miss Delano on August 3^ 1918; 

deferring to your recent letter relative to the admission of 
Catholic Sisters to the Army Nurse Corps, I am directed by 
the Surgeon General to inform you that a recommendation 
has been made to the Secretary of War to the effect that 
chould the Sisters be admitted to the Corps, as graduate 
nurses, they nuist^ when on duty in the wards, wear the uni- 
form of the Corps, w*ith the exception of the head covering, 
which may be a modification of the nurse's cap which will 
satisfactorily meet the situation. 

It is further recommended that, when on the street, they be 
permitted to wear the hal>it of their order. Until a reply haa 
been received from the War Department, a definite decision 
cannot he rcconmiended. You will, however, be advised as 
soon as the reply has been received 

Serviw in the Army Nurse Corps was made possible for th6^ 
Sisterhoods on September 10, 11)18, in the following order 
transmitted by Colonel Smith to Miss Delano: 

Your attention is invited to the recent decision of the 
Adjutant General as quoted below, 

1. Orders are being issued directing that Army Nurses who 
are members of Catholic orders, whose vows require the wear- 
ing of a distinctive garb, are authorized to wear the garb of 
their order while traveling un lan<l in this country without 
troops and while traveling on transports. 

2. You will prescribe a suitable device to bn worn with this 
religious garb, which will clearly mark the wearer as a member 
of the Army Nurse Corps. 

3. You will also prescribe a cap to cover tlie entire head 
which shall be worn by them while on duty. 

The device referred to in jmragraph 2 will be the regular 
insignia of the Army Nurne Corps: the letters TT.S, and the 
badge or caduceus with the gilt letters "A.N.C." superira- 
poped. This insignia will be worn on the Sisferhoml garb at 
such times when it is approved that they be worn. The Super- 
intendent of the Army Nurse Corps will prescribe the cap to 
l>e worn. 

By direction of the Surgeon General. 




IlELATION OF NURSING SERVICE TO THE ARMY 879 



On Aiiguat 1, 1018, the Surgeon General of the Army re- 
quested the American Red Crosa to make preparations throngh 
its Now York Bureau of Equipment to lit out completely one 
thousand nurses a week for overseas duty. The staff of the 
Bureau of Nurse^' Equipment then numbered twentj'-two per^ 
sons. '*Mr8. Moody and all her assistants/' wrote Miss Johnson 
to Miss Noyes on August 8, "are as anxious as we are to have 
the nurses ready, even thoiijrh the Army may not hv able to send 
them over as rapidly as we can equip them." Men and women 
who Wfrc doing war work in Washington and in Xew York 
during the opprpssivp heat of Augtist und September, 1018, will 
appreciate in part the intense strain under which all branches 
of the Government were lu]n)ring. 

Wliile the New York Bureau was stnig^liug with the problem 
of e<juipment, the Chief Surgeon of the American Expedition- 
ary Forces notified the American Ked Cross Commission in 
Puris that the Nurses' Kquipment Shop there would pmbahly be 
caljod up^n during the early antiinin to replenish at coat wnm- 
out articles of clothing for ten thousand nurses and to furnish 
extraordinary equipment for nurses assigned to the zone of 
advance, especially those of forty mobile hospitals. 

The early base hospital units assigned to the British forces 
had sailed before the American Red Cross made its generous 
appropriation for equipping nurses. The London Chapter had 
«ent them gray imifomis, aprons, boots, rain hats, rubber sheets, 
woolen knickerbockers und other necessities. Great need ex- 
isted, however, in France for some central agency through wliich 
inequalities in the initial supply of and replenishment of worn- 
out articles could be adjusted. 

Through the efforts of Martha M. Russell, first chief nurse 
of the American Red Cross Commission to France, more ade- 
quate winter clothing and shoes had been forwarded to nurses 
in bases of the British and American forces during that first 
bleak winter of active ser\'ice. But the Red Cross had never 
undertaken to reequip nurses free of charge, nor was it then 
doing so. In a letter written Novemlw^r 16, 1017, to Miss 
Russell, Miss Noyes stated jhat the Red Cross ''could hardly 
undertake the replacement of worn-out articles in any wholesale 
rVay. As nurses are on a salary," she pointed out, "there would 

'ra to lie no reason why they should not provide such ad- 
ditional articles as are required in the same way that they 
TDuld do were they in this c/)iintry," 




380 HISTORY OF AMERICAN RED CROSS NURSING 

An interesting comment on the equipment question was oon- 
tainrd in a letter written June 13, 1918, by Miss Russell to 
Miss Delano: 

The equipment now given the nurses is generous and suit- 
able. I think there is some feeling among the nurses that they 
should be clothed all the time that they are in the service and 
I think that Major Perkins thought I was a stingj* person 
be<«u.se I stood by the statement we liad when I Jirst went to 
France, that the Red CroSs furnished initial equipment and 
then the nurse attended to her own needs afterwards. I 
believe that there is a certain pauperizing effect in giving 
equipment. The British give each nurse a sum of money and 
require her to present herself with the regulation outfit for 
inspection. Xow our way results in greater uniformity, but I 
have heard so much complaint that I would like to see each 
nurse made to feel more personal responsibility about her 
equipment. 

As to salaries, in the general emotional upset due to war 
conditioui, it is highly difficult to adjust money matters. 
The service the nurses can render is priceless; yet I believe 
that every one who goes into the service really believes in her 
heart* as one of them said to a man who asked lier if she was 
to get a bigger salary than she had Ijeen receiving in civilian 
work: "It is my privilege to serve my country and tlie 
allowance is sutTicient for all my needs." I really believe that 
the nurses' pay of sixty dollars a month and maintenance is 
not so great a reduction in income for the private duty nurse, 
if taken in the average, unless of cour.so she is depending ou 
"gifts" as too many do. For a school nurse there must be a 
decided advantage in the sixty dollars salar}' and five hundred 
francs maintenance. However, the nurses complain now and 
then to the men in Paris, men whose wealth makes them think 
the sixty dollars is barely enough for an evening's entertain- 
ment, and they pity the nurses and encourage them to ask for 
further gifts in the way of equipment. . . . 

If the Kwl Cross could make possible a systematic, inteUi- 
gent development of e^ifnii de corps in the American military 
nnrsing service, it would be a far greater gift to the nurses 
themselves and to the profession than any amount of fur 
trench coats and pianos tor recreation houses. . . . 

Early in the spring of 1918, the Red Cross Commission for 
France felt tliat the establishment of an equipment center in 
Paris where nurses could s<»cure articles of clothing and equip- 
ment to replenish worn-out ones at coat, or nearly cost, would 



I 



RELATION OF NURSING SERVICE TO THE ARMY 381 

be a great convenience. The War Department and National 
Hfadquarters concurred in this opinion and a Nnrscs* Equip- 
ment Shop was developed and maintained at the Paris Head- 
quarters, under the chief mirap of the American Reil Cross 
in yranee. A report of these activities will be found in a sub- 
sequent chapter. 

The first definite movement of the Government to furnish 
equipment for Army nurses was made in August, 1918. Gen- 
eral Pershiujtf then cabled to the War Department, requesting 
that forty-three thousand pairs of shoes, riibhers, raincoats, 
summer underwear, uorfolk jacket suits in rcguUition sizes, 
ooaCs, hats, etc.» should be sent to France at Government expense, 
a recjuest which argued towards the possibility that the Ameri- 
can Expeditionary Forces contemphjted the establishment 
under their otati direction of a department for the replenish- 
ment of nurses' equipment and uniforms. 

At the crisis of the nursing situation, when the War Depart- 
ment was calling for fifty thousand graduate and student nurses 
by July, IDll), Colonel Winford Smith, Medical Corps, took 
up again in a letter written November 0, 1S}18, to the General 
Manager of the American Red Cross, the old question as to 
whether the lied Cross or the Army should pay for nurses* 
equipment: 

I am directed by the Surgeon General to acknowledge the 
receipt of a reeent letter from the general maiiiiger of the 
Red Cross, stating that inasmuch as the War Council of the 
Red Cross understands that the Government is to provide for 
the equipment of nurses for overseas service, the Red Cross is 
preparing to disband its organization which has had this 
phase of work in hand. 

The Surgeon General has again reqiiei^ted that the Govern- 
ment equip the nurses, hut at this writing we have no assur- 
ance that favorahie action will be taken on this request. 

Inasmuch as we helieve that it would seriously interfere 
with the recruiting of nurses who are so urgently needed, if 
the Red Cross stops issuing equipment and the Government 
fails to provide for it, it is hoped that until definite arrange- 
zuents have been made hy the Government, the Red Cross will 
feel like continuing its custom of equipping the nurses as 
heretofore. 



General Peyton C ^farch, Chief of Staff, issued on December 
17, 1018, General Orders No. SG, as follows; 



382 HISTORY OF AMERICAN RED CROSS NURSING 

In order to enable them immediately to comply with regu- 
lations requiring the wearing of uniforms, a single initial 
uniform outfit is hereby authorized for iseue to members of 
the Army Nurse Corps upon their first entry into the 8ervic€(^| 
as follows: One navy blue norfolk Buit; one navy blue over-™ 
coat; one navy blue flannel waist; one navy blue velour hat 
for winter; one navy blue straw hat for summer; two sets 
inaignia, United States; two pairs in&iguia, badge of Corps. 

When members of the Army Nurse Corps are ordered to 
duty overseas with the Ameriran Expeditionary Forces, the 
following articles will be issued io them: six gray cotton uni- 
forms; one gray woolen sweater; one gray woolen muffler; one 
raincoat; one blanket for use on transport; one sleeping hag; 
one steamer trunk. 

2. Nurses who have been enrolled for service during the 
existing emergency and who have not been supplied with 
■ uniform outfits by the Amoriraii Ked Cross without cost to 
themselves, will be entitled to the issue herein authorized. 
The Quartermaster General will supply the necessary articles 
of uniform for issue and sale at cost price, when issue is not 
authorized. The details of material, make and design will 
conform to the specifications prescribed by the Surgeon Gen- 
eral and no change therein will be made without his authority. 
By order of the Secretary of War. 



The American Red Cross at its New York Bureau INursea' 
Equipment cquippcHl between April 7, 1917, and December 
31y 1018^ the following perdouiiel for overseas duty: J 

Ahmy 

10,519 Nurses at an average of $180 each $1,893,430.00 

2GG Civilian employees at an average of $180 

each 47,880.00 

134 Dietitians at an average of $180 each. . 24,120.00 
>6£ Reconstruction aide«, at an average of 

#180 eadi - 65,700.00 

$2,031,120.00 
Navy" 

334 Nurses at $180 each $60,120.00 

■Thpsp fl^fures aro inc)ud(><l here to j^ivo an id** of th* proportion of 
•rrvicc rendered by the Rw! Crofts to the Army in comparison to tliat 
riven to the Navy and to R<h1 Cruaa foreign commiHsiona, alao to giva 
ID on« table a complete Hummary of the artivitiea pf the Burpau of iiuT$eti* 
EfjtiipmenL 




RELATION OF NURSING SERVICE TO THE ARMY 383 

Red Cross (Foreign Activities) 

673 Nuwes at $180 each $103,140.00 

351 Nurses' aides at $100 each 35,100.00 

4 Dietitians at $180 each 720.00 



$2,230,200.00 



SI 



Of the equipment, Miss TToyes wrote in her request to the War 
Council for an appropriation to cover these expenditures: 

A maximum amount allowed for equipment was $200 

^r individual, but ouly in a few instances was this amount 
[iven, while in many other instances it fell below the $180. 
'he average cost per nurse for the equipment was $180 
each. 

The equipment for the nurses' aides was approximated at 
$100 each. Some of them were given entire equipment, 
others partial, while in a great many instances the equipment 
was provided by the nurses' aide. 

These figures do not include the equipment issued to the 
nurses in home service, which consisted of the cape; neither 
does it include the equipment issued to the nurses in the 
sanitary' zones, as thit is provided from a separate appropria- 
tion. The approximate amount of money spent for capes at 
the present time was $280,000.^ 



ai 



The Red Cross appropriated more than throe million dollars 
)T equipment for nurses, nurses' aides and dietitiuus. The 

timates which Miss Noyos gave above were based upon the 
"ratio of $180.00 for each nurse. Equipment required for some 
nurses exceeded this amount and required the expenditure of 
$200, the maximum which the War Council allowed for an 
individual. Prices of materials and labor varied from time to 
time and these conditions caused equipment to exceed three 
million dollars,'^ 

Clara D. Noyes, Caroline Van Blarcom, Florence Johnson, 
Sophie Kiel, Mary Magoun Brown and !Maude G. Moody stand 
out preeminently among the group of Red Cross women whose 
interest and tireless effort made smooth the embarkation of 
those thousands of overseas workers. Sophie Kiel (St. Luke's 
Hospital, N. Y. City) was Miss Van Blarcom's and Miss 
Johnson's assistant in the Atlantic Division. Following her 

"Hre American Red Croaa War Council Request for Appropriation No, 
MS. F«bniary 14, 1919. 
""The Work of the American Red CroaB during the War/' p. 33. 



884. HISTORY OF AMERICAN RED CROSS NURSING 



return from Khoi, Persia, iu 1016, shr* organized oiio 
Red CroBs detachments for the ^Navy. Though her status con- 
tinued as that of a Navy chief mirse, the auf>eriulendent of the 
Navy Nurae Corps released her from active service to assist 
in the Atlantic Division until August 22, 1918, when she was 
assigned by Mra. Higbee to the U. S. Array Transport Oeorga 
Washington, 

The attitude of mind which chnritoteri/.cd the Ked Cross: 
executives and their assistants who linndled the often vexatio 
details of equipment was described by Miss Brown, herself a 
member of Miss Johnson's staff. **As I recall those busy days/* 
she wrote, **onc outstanding point remains freshly in my mem- 
ory. Miss Johnson and her associates drew so much vivid 
interest and enthusiasm from the new jijoups of nurses coming 
from all parts of the country, all fired by the same ideals of 
Bervice, that they themselves seemed forever unmindful of 
personal fatigue and genuine labor and inconvenience." Mrs, 
Moody wrote, "Annisticre Day found the Burean of Equipment 
with an organization of thirty more than willing workers, a 
staff which knew no hours of service, — its inspiration gained 
from that long line of nurses who, with never a thought of self, 
just marking time until their actual work overseas might begin, 
had come and gc)ue l>efore us." 

National Headtiuarters provided other comforts for the wel- 
fare of American nurses iu Army service overseas and mention 
of tliem may bo included in this rhapter. The Minutes of the 
War Council, which record uU appropriations made from the 
Red Cross coffers, briefly mention two other items. On March 
19, 1917, $77,500 was appropriated, "of which so much as may 
be necessary shall l)e expended for the purchase of 'safety suits' 
for the use of nurses and members of hospital staffs, with the 
understanding that should tlie War Department wish to reim- 
burse the Red Cross for these suits, it should be permitted to 
do 80." *' The high seas were alive with U-boats. In addition 
to keeping a person afloat for an indefinite time, these partioilar 
safety suits afforded protection from exposure, "a cause of manj' 
of the deaths," stated this minute of the War Council, "follow- 
ing the sinking of ships." 

Before the declaration of war on Germany by the United 

States, the War D<'purtment hud allowed forty cents per day 

for food for Army nurses and patients. This allowance could 

"MiDUtM of the War Council, Vol. III. pages 787-789. 



ISftS 

Uff^l 




I 

I 

I 

I 



RELATION OF NURSING SERVICE TO THE ARMY 385 

not be changed without Congressional action. The Surgeon 
Genoral accordingly asked the Red Cross to assume the re- 
sponsibility of providing the difference between the legal al- 
lowance and seventy-five cents, which was conceded to be a 
proper amount of subsistence. For a period of eleven months, 
these thirty-five pennies given daily for food for every Army 
nurse and every sick or wounded soldier in Europe amounted 
to well over $185,0(17. "Colonel Ireland," recorded the 
Minutes of the War Council for May 18, 1918, "stated that 
ample provision baa now l>een made by the Government for the 
sick in hospitals and for the members of the Army Nurse 
Corps." 

The Red Cross furnished Jaiiiidry allowance for nurses serving 
on the Mexican border, but did not make similar provision 
for nurses on duty during the European War in the cantonments 
or on foreign assignments because of the vast amount of clerical 
detail that would have been required. 

Whatever the American Red Cross did for the war nurse, 
were she of the Army or Navy, the U. S. Public Health Ser\'ice 
or the Red Cross, was given back indirectly in service by her 
to the American soldier. His comfort, often his very life, de- 
pended upon that gray-uniformed nurse who from time to time 
accommodated her own personality to the needs of her patients; 
she was sometimes cheerfully frivolous; she was sometimes 
seemingly callous and unsympathetic; she was sometimes the 
very reincarnation of that woiniiu who sixty years ago walked, 
lamp in hand, among the wounded at Scutari. That nurses 
themselves were grateful for the gifts which American gen- 
erosity enabled the Red Cross to make them, is shown in tbia 
one letter chosen from among many of similar content: 

American Expeditionary Forces, 
France, September 27, 1918. 

Everywhere we look, everywhere we go. there arise evi- 
dences of your consideration and love. The wardrobes you 
gave us best manifest this. 

It is hard to determine which of the articles you chose are 
the most useful and uttructivo. When we notice how the 
peasant women eye us, we think it is our smart jackets and 
skirts. When the weather gets cold and our ulsters fit snugly 
about our throats, we are sure we need these great coats more 
than anything else. When it rains the next day, we exclaim, 
*'My. wasn^t it lucky for us that the Kod Cross gave us boots. 



886 HISTORY OF AMERICAN RED CROSS NURSING 

slickers and raincoate!" When we crawl into bed at night 
with hands and feet numb with cold, we bless you for giving 
ns warm pajamas and sleeping bags. But when the gray 
morning comes all too soon, then our wool underwear cer- 
tainly feels best of all 1 

Many times when I have been lonely, heart-sick, soul-weary^ 
the sight of my equipment and the thought of why it was 
ffiven to me has brought me new courage, has nuule me into a 
better soldier. 



CHAPTER Vn 



THE EUBOPEAX WAB 



Cantonments of the New Armie» — Embarkation — With the 
American Expediiwnary Forces in Great Britain — Wiih the 
American Expeditiananj Forces in France—'The Zone of 
the Base, A, E, F. in France — The American Red Cross 
Commission for France — Nurses' Equipment Shop, Paris — 
With the French Servi<^€ de Sanfe — Emergency Hospitaliza' 
tion, A. E. F. in France — The Zone of the Advance, A, E, F, 
in France— With the A. E, F. in Italy— With the A, E. F. 
in North Russia 

THE United States entered the European War on April 6, 
1917. Twenty da^B IuIlt tlie Aiiu'rieun Xuraea' Assoeia- 
tion met for its Twentieth Annual Convention in Phila- 
delphia, with a record attendance. The Red Cross session was 
held on Monday evening, April 30, in the Academy of Music. 
Every one of the 3000 seats was filled and all availahle standing 
room occupied. In the red, white and blue of the Red Cross 
uniform, nurses sitting in the orchestra, the balcony and the 
cileries formed line upon line of color, splendidly vivid against 
the somber-hued furnishings of the auditorium. Their faces 
Under the winged Red Cross cap were tense and expectant. 
HealLzation of the responsibilities soon to be placed upon them 
bushed the idle conversation which usually runs lightly through 
an audience before the program begins. On that night, the very 
air seemed charged with patriotic ardor. 

Miss Noyes, Dr. Warren P. Wilson, of Columbia University, 
and Eliot Wadsworth, acting chairman of the Red Cross 
Central Committee, were the speakers of the evening, Miss 
Delano presided. Her introduction of Miss Noyes was prefaced 
in part by the following words: 

It is eight years ago this month since I stood before the 
American Nuraey* AssociHtiun and be;»ged of them to ratify 
the affiliation which the IM Cross had offered to us and to 

387 




388 HISTORY OF AMERICAN RED CROSS NURSING 



pled;:,^ti thenuswlves to the orgauizatiou of a Nursing Service 
which 1 believed we should organize for the benefit of our 
country. At that time, so far as I know, all the nations of the 
earth were at jieat'c. We bejxan this work with no thought 
that within a «^om[)iirativcIy short period, eight years, we 
should be called upon to meet the needs aud service of the 
greatest and moat horrible war that the world has ever 
known.* 

After giving an outline of the development of war nursings 
Miss Noyes voiced the responsibility confronting the American 
nursing profession: 

As I stand faring you to-night, sister nurses, under the 
shadow of war, we know not what we as nurses shall be called 
upon to do. We know, however, that our Red Cross Nursing 
Service exists but for one purpose, — the reserve of the Anoy 
and Navy Nurt^e Corps in time of war. You may be called 
upon to give fully, tn make great personal sacrifices, but we 
know you are prepared, we know that you are ready, we know 
that we can depend upon you to carry the spirit of Red Cross 
service, as well us its banner, wherever our Army and Navy 
may be sent, whether to tlie Pacific or Atlantic coasts, to the 
cantonments, to the frontiers of France or Russia, or to far- 
dietant Mesopotamia. It must be written upon the pages of 
history for all time that our Red Cross nurses were prepared, 
that in this war our wildiers at least were not neglected and 
tiiat they were properly nursed.* 

Following an address liv Dr. Wilson on Rural Nursing, Eliot 
Wadsworfh, acting chairman of the lied Cross ('cntrai Com- 
mittee, spoke in part, as follows: 

In these days of alarm and excitement, when the whole 
country is thinking of war and when at every cross-road and 
in every railroad train the pwii)Ie are debating as to the extent 
to which the country is prepared ... I have come here really 
to say a word of appreciation for what the nurses have done 
by their systematic organization, and what they will be called 
upon to do, now that the need has arisen. The Rcfl Cross has 
enrolled for service more than 8000 nurses whose qualifica- 
tions are known, who have taken all the steps required by the 
Army Medical Corps to permit their immediate enlistment in 

^23rd AhouaJ Report, National League of Nursing Education, 1917, p. 
223. 



THE EUROPEAN WAR 



389 



i 



I 



this service. . . . And as a resultj the Red Cross Nursing 
Service is ready at this hour, more ready than perhaps any 
branch, official or unofticial, of tlie United Slates.* 

As Mr. Wadsworth concluded, the vast body of American 
women rose as one and fjlodged themselves *'to give our best 
service to the nation whcrcvt-r culled upon to render it, either 
in home or foreign field, in tht> daily routine of civil or military 
hospital, or in the equally great effort to conserve, protect and 
strengthen the health and endurance of the civilian population, 
the men, women and children at home in our Jund." 

Even then, the call to the colors had sounded. Orders for 
the immediate mobilization of sis Red Cross base hospitals for 
duty with the British Expeditionary Forces had been sent the 
day before, April 2i), by the Surgeon General. One after the 
other, these and other Red Cross sanitary units were assigned to 
active foreign service, while at home the building of future 
American Armies, of which nurses were to form a vital part, 
began. 

History was swift in the making during that memorable 
spring and summer of 1917. Congress in special session passed 
the Selective Service Law on May 19 and the first registration 
on June 5 brought tJionsanda of recruits to the cantonments of 
the new Armies. The building of sixteen camps for the Na- 
tional Guard and sixteen cantonments for the National Array 
had been authorized in ^tay; the last site for these temporary 
gray cities was 8<»curcd on July 6- Accommodations were ready 
on September 4- for 430,000 men. This capacity was shortly 
increased to provide for the care of 770,000 men, an average 
capacity per cantonment of 48,000. Divisions of the Rc^ilar 
Army were trained both in camps and cantonments and at 
Tarions Array posts. Training schools for the Artillery, Avia- 
tion. Engineer, Tank and Quartermaster Corps and for Chem- 
ical Warfare were established, with proving grounds and testing 
fields. Embarkation camps were bnilt at New York and New- 
port News and afforded housing accommodations for more than 
300,000 men.* 

Each of the thirty-two camps and cantonments included aa 
part of its organization the development and maintenance of a 

'American Journal of \urting. Vol. XVII, pp. 1153-57. Srptcmbor. 1917. 

•"The Wftr with GtTtnatiy, A Statisticnl Summan," Lt-onanl P. Avree, 
Colunel, Oenerul Staff. U. S. Army, pp. 17-29. 'Government Printinjr 
Office. Wa»!iington, U. C, 1919. 



890 HISTORY OF AMERICAN RED CROSS NURSING ■ 

hospital of one thousand beds. The nurses of these hospital^™ 
were secured largely from Ked Cross emergency detachments. 
In a letter written September ^2, 1917, to all Local Committees 
on Red Cross Nursing Service, Aliss Noyes stated that "we are 
being asked for many hundreds of nurses for cantonment duty. 
. , . Will you not *round up' as many as possible for this work ? 
The physical examination of each nurse will, of course, have 
to be on file in this office before she can be assigned to duty, 
but it will not be necessarv for her to complete immunity treat- 
ment." iH 

The Surgeon General also asked the Nursing Service tcT™ 
nominate chief nurses for several of the cantonment hospitals. 
Susan Hearle, Alice Beatle, of the Mercy Ship Relief Expedi- 
tion, ^lary Roberts, Estelle Campbell and Sophia Rutley were 
appointed. "Each chief nurse," wrote Miss Noyes in the Red 
Prosa columns of the Journal of Nursing for November, 1917, 
"has l>een asked to organize groups of nurses as a nucleus for 
her personnel, but should she not be able to secure the rerjuired 
number by the time the cantonment hospital is ready for occu- 
pancy, it is expected to fill the deficit from emergency detach- 
ments." 

As rapidly as barracks could be erected in the cantonments, 
they were filled with recniita fmm the Selective Draft. Base 
hospital construction, including the erection of nurses' quarters, 
waa deferred tmtil after the barracks were completed. The need 
for medical and nursing service increased, however, with each 
new assigiiTnent of men to the cantonments. Immediately upon 
their nrrivfll, the "rookies" were inoculated for various con- 
tagious diseases and many of them became ill. Others, long 
accustomed to more sedentary and luxurious habits of living 
and to food different from Army rations, were slow to become 
acclimated to the rigors of military life and so fell an easy prey 
to disease. Thus cnme about the acute need for nurses in the 
camps and cantonments, which Mites Noyes set forth in a letter 
written October 30 to all Local Committees on Red Cross Nurs- 
ing Service: ^B| 

We have just received a definite call from the War Depart- 
ment for nenrly 7i'^0 nurses for immediate cantonment service. 

The yatioTinl Conunittee feelH very strongly that this seri- 
ou» need shouM he brought very forcibly to the attention of 
individual memhere of the Red Cross Nursing Service. It is 
far from patriotic, far from the purpose of the Red Cross to 




THE EUROPEAN WAR 



391 



Lve nurses continue to refuse liome service where the need is 
urgent, in favor of foreign assignment, where tlie demuiui is 
not 80 great. Nurpes whom the committecji consider available 
for cantonmenta and who continue to refuse service should be 
reported at once to National Headquarters. 

The need is indeed pressing. There are from 600 to 800 
desperately ill men in several of these hospitab, with an 
average of ten nurses on duty. 

Nursea themselves held back from volunteering for canton- 
ment service because they felt that foreign service would Ik? more 
attractive, more interesting. In the January, 11»1S, issue of the 
Anurican Journal of Nursing, Miss Palmer, the editor, a;)Uiidly 
rated the nursing profession iu an editorial bearing the title: 
"Are we slackers I" 



Appeals are being made constantly from Red Cross Head- 
quarters for the enrollment of nurses for home service. The 
situation is rendoroJ difficult for the reason that nurses who 
are enrolled in base ho^pital^ are being held back to some 
extent for foreign service, while many others are failing to 
respond because they are hoping for a chance to go abroad and 
desire to do that rather than volunteer for service in the can- 
tonments iu their own country. 

The waiving of one of the requirements for enrollment in 
the Red Cross, that of memhersliip in the American Nurses* 
Associtition, will make large numbers of nurses eligible who 
have been debarred up to this time. We wish to call the 
attention of our readers again to Miss Delano's report in the 
Last issue of the Journal, which showed that during the war 
period the age limit is abolishetl so that older women who are 
in vigorous health may ho enrolled for home service. It is 
going to be possible, also, for nurses from the smaller hospitals 
to be recognized under certain conditions. 

One reason given by nurses of all ages for not enrolling is 
that their fannlics object to their serving. We want to say 
that if any woman is old enough to be out in the world sup- 
porting herself and perhapir helping her family, she is old 
enough to decide such questions for herself. 

Returns which are conntig in from the survey of nursing 
resourc-es being made throughout the country show that a 
comparatively small proportion of the registered nurses, in the 
twenty states tlmt have reported, are enrolled with the Red 
Cross. The percentages vary from one and three-fourtlis, 
which is the lowest received, through seven and eight, which 



3d2 HISTORY OF AMERICAN RED CROSS NURSIX( 



are the most common, to thirt>'-two niifJ fortynjue, the 
being to the credit of the Dii^trict of Culumbia.. 

Do not let it go down in history that wlien the young men 
of our country were called into service in defense of the 
democracy of the world, the nurses held back, because of 
financial reasons, or because they alirink from the hardshi 
of war service. 



4 



Among letters of sharp criticism which came to National 
Headquarters was one which had been written by a registered 
nurse fifty-eight years old. After roundly upbraiding younger 
nurses who refrained from (ttTcring their si^rviecs, she asked 
for assignment in tlio Army Nurse Corps. In replying to her 
on February 28, 1018, Miss Delano gave the fullowiug reason^^ 
for the existing shortage of nurses: ^H 

In the first place, camps were erected before the hospitab 
were built and I believe the hospitals took precedence over the 
nurses* quarters. Bringing hundreds of thousands of young 
men together in camp life made it possible for an epidemic of 
contagious diseases to develop, which came on in a great flood 
before adequate preparations had been made for their care. 

In some cases, quarters for n\irses were not available. In 
other instances, there was temporary difHculty in securing an 
adequate number of nurses to meet an emergency. This was 
due to various causes, chief among them, I believe, being the 
fact that we had several hundred nurses mobilized and waiting 
for service. This fact was generally known throughout the 
country. It was, therefore, difficult to convince nurses at 
large of the extreme need when they knew that at the same 
time we had ncveral hundred nurses mobilized at Ellis Island 
who were not culled upon for cantonment duty. It was diffi- 
cult to explain to nurses at large that these groups at Ellis 
Island might rttceive mailing orders at any moment. 

We have met all the demands of the Navy and the U. 
Public Health Service and, I believe, are meeting satisfa* 
torily today the needs of the Army. This is. I think, provi 
by the fact that we are enrolling over a thousand nurses 
month and are sending large numbers into immediate eervn 
both at borne and overseas. 

I agree with you, however, tliat if we as a profession are 
meet the obligations tliat this war has thrut:t ujmn us, tl 
rank and file of the nursing profession must realize that notf 
ing is more important than the care of our soldiers here in oi 
own country. 



THE EUROPEAN WAR 



393 



After the adoption of the ruling that nurses should be "sent 
to cantonment hospitula in this country to determine their pro- 
fessional and physical fitness for overseas service/' many nurses 
from the staifs of base hospital units were assigned to canton- 
ment duty. But the need for nurses in this branch of the service 
still continued. On May IG, 1918, Miss Thompsou wrote Miss 
Noyes that "in view of the fact that 550 'casuals' are to be rushed 
to Europe in addition to the base hospitals now awaiting trans- 
portation in New York, the oantonmcnts will bo in urgent need 
of nurses, I fear, in a short time. . . , Therefore, will you not 
do all within your power/' she concluded, ''to nominate as many 
inirsps as possible for immediate duty 'i One thousand could 
be placed today without difficulty," 

Cantonment service was full of the hubbub, the change, the 
excitement of armies in the making. Emergencies made up the 
IBiy fabric of the nurses' crowded days. Rachel Golzar, Re- 
fcre Nurse, A. N. C, wrote from Camp McClellan, Anniston, 
Akbama: 



A few months ago, this region was a stretch of wilderness. 
The first division of men worked this place through to what it 
is at present. The hospital is perched on a hill-top and below 
the hill are the drill grounds and tents. The camp groimd 
occupies some seventeen thousand acres. The base hospital, 
extending over yixty-two acres, has at present thirty-two 
wards: more are in process of construction. Surgical wards, 
a medical and dental tlcpartmcnt. X-ray room* nose, ear and 
throat section, eye clinic, contagious and tuberculosis divi- 
sions; one ward for mental cases and one ward for sick officers. 
comprise our line-up. Each ward is a barracks by itself. We 
have now between six hundred and seven hundred patients 
and a wide variety of cases, perhaps more than in any large 
hospital of a city. 

When we seven arrived, we found ourselves the first group 
of nurses that ever trotted these proundH. We were not ex- 
pected so soon nor was anything ready for us. No department 
store in New York, however, delivered things more rapidly 
than the Quartermaster Corps brought us beds, furnishings 
and other comforts. 

In our wooden barracks, acrid with the pungent odor of 
raw pine, our rooms already have dressers and little rugs. 
Small rockers, shades and scrim curtains have arrived. We 
expect our own cook and two maids later to attend to the 
nurses' home. 



894 HISTORY OF AMERICAN RED CROSS NURSING 

The American Journal of Nursing published in May, 1918, 
a fipeciai Military Number, which was made up of articles which 
had beeu writteu by nurses in various types of war uursiug aud 
which described their perscinal experiences. As Miss Delano 
took a large part in securing these articles, extracts from them 
are quoted as primary sources in this history. 

Of the cantonment near Boston, at Ayer, Massachusetts, Jane 
G. Molloy (City and County Hospital, San Francisco) wrote: 

Camp Devens, named after General Devens of Civil War 
fame, is in the Northeast Division. Its development, spread 
over ten thousand acres, is a feat of engineering. Twenty 
miles of road were laid ; four Imndred miles of electric wiring 
were done; sixty miles of heating pipes were connected, all in 
less time than is ordinarily taken to erect our municipal 
buildings. 

It is a small world that you must see for yourself. The 
hot:pitai itself is a little town. Its tnjrridors measure three 
and one-half miles. They are enclosed and each is named as 
are streets in a well laid out village, each ward numbered as 
are houses in a city block. 

Patients who filled the wards of cantonment base hospitals 
during liJlT and during the spring and summer of 1918 were 
generally medical and contagious and accident cases. Soldiers 
wounded in active service in France had not yet begun to come 
back to tiie United States. However, the nurses who were 
assigti(*d to cantonment duty worked very hard, especially dur- 
ing the epidemic of coutagious diseases to which ^liss Delano 
referred in the letter of February 28, liUS, -quoted alKive. The 
virulence of tliis epidemic and the need which it caused for 
expert nursing service was descrilK^d by Eleanor Hall, Army 
Nnrse Corps, in a letter writteu from Camp Taylor, Louisville, 
Kentucky : 

On April 1, 1918, T was assigned to day duty on "7C," a 
pneumonia ward. We seem to work in a trpadmill here; we 
rush from morning till night and yett in spite of all we can do, 
the boys get sicker and sicker and we have had several deaths. 
The other day we lost one, measles, bronchial pneumonia and 
meningitis. It seemed as if his head was filled with pus 
which ooxed from his eyes, his ears, his nose and mouth. . . . 
When one gets measles here, it is serious, for the infection 
which cnuscs measles also causes abscessed eyes, ears, throat 
infectious^ and Uien it goes to the lungs and we have paeu* 




THE EUROPEAN WAR 



395 



monia, bronchitis, erysipelaa (there are four cases in the ward 
now) and pleurisy. Between the Inst day of health til! the 
first day of **at the point of death" is sometimes only thirty- 
six or forty-eight houra. 

Ethel Haigitt (St. Miehaera Hospital, Toronto, Canada), 
reserve nurse, wrote in the Milltarv Numlior of the Journal 
of her work at Fort Riley, a Regular ^Vmiy Post, near Junction 
City^ Kansas : 

They were very busy on the wards, so we were asked to be 
ready for duty by nine oVIock. The large gray stone huild- 
inga, which had been previously ut^ed as barracks, baud qimr- 
ters, prison, mess hall, etc., were fast being cleaned, painted 
and remodeled; also a very good plumbing system was beinj' 
put in. As we walked along Cavalry Drive with the chiet 
nurse, she requested us to wait for her while she took one of 
our number into one of these buildings known as sections, 
where she assigned her to duty. So we passed on until it 
came my turn and I was ushered into a section marked *'C/' 
''Isolation/' "Measles." 

Here I found two nurses and a head nurse, but the one 
whose place 1 was taking was to go on night duty. This 
Bection, though full of jmtients, probably 140, had only had 
nurses there for about two weeks; there were none to put there 
before. Here, as in other sections, the carpenters and plumbers 
at work. 
iS you may judge, we were very short of nurses through all 

le Fort. We decided to put all the sickest patients and those 
requiring the most treatment in one large ward, thereby saving 
time and steps. We found the ward masters and corpsmeu 
invaluable helpers, many times willing to do things out of 
their province. During the first two weeks I must admit I 
was very tired and the bed looked good to me at night. We, 
the day staff, had only eight-hour duty; that usually mcaikt 
four hours on and four hours off. The night nurses worked 
twelve hours. 

When 1 had been in this section three weeks, the chief 
nurse informed me that she wished to open another building 
(by that nhe meant to place nurses in it) and wanted me to 
take charge of it. Being still short of nurses, she could give 
me only one. but promised more as soon as they could be 
obtained. When I left, I had nine nurses for day and three 
for night duty. So you see she kept her promise. . . . 

Within a few weeks, the epidemic was checked and the 
presaure of work lightened proportionately in the cantonment 




896 HISTORY OF AMERICAN RED CROSS NURSING 

hospitals. Then the nurses enjoyed an eight-hour day, which 
gave ample opportunity for re^t and recreation. Jane Molloy 
wrote of the facilities for recreation at Camp Devcns: 






Do not believe that a nurse is always *'over-worked'* in the 
Army. When she leaves the wards, she is compIeLely and 
gloriously "off duly.*' This total freedom from all respooai- 
bility means an opportunity to relax and enjoy the interv. 
between hours of duty, rarely possihie in other voeations. 

Nor is there deartli of entertainment. Something is go 
on at all times. Tliongh it is work for the eompany to drill, 
it is entertainment for the observer. 1 have yet to see a com- 
edy staged tliat can compare with the ''Awkward Squad/' 
Many of the liest plnys of the season have hmm produeeil at 
our camp theater. The Boston Symphony Company gave one 
of it** fine concerts here during the winter; and the movies are 
always to be seen. 

And above, around and behind all this, the great, stupen- 
dous work goes on — the training of brawn and muscle, of mind 
and will. The Army changes no one; it simply proves what 
we are. 

In its professional phases, military nursing differed greatly 
from institutional or private duty nursing. In a letter written 
from Camp Taylor, Louisville, Kentucky, Eleanor Hall de- 
scribed these aspects : 

The nursing experience we get here is invaluable. We learn 
much in various linea which is not enscntial in private duty 
nursing but which is very necessary in Army service. The 
nurses have come from all types of schools, from all states and 
from all walks of life. They are thrown together here and 
must quickly accustom themselves to the Army discipline. 
Length of service at a given post, and that alone, puts one 
nurse above another. The head nurses for the wards ore 
selected entirely from among the nurses who have been longest 
at Camp Taylor. In a ward, the heud nurse rules, except that 
each nurse is free to do her work according to her training, 
provided, of (i)urse, that she does it correctly. When a ques- 
tion arises* however, the nurse who has been on duty for the 
greatest length of time in the ward ha? the greatest amount of 
authority. We must learn to accept this, . . . 

We must learn to close our eyes to many things which we 
would like to do, and stick instead to the eftsentials. We must 
refrain esiHN^ially from doing anything or everything that tlic 
orderlies or the patients can do, because there is so much to 




THE EUROPEAN WAR 



397 



be done that a nurge alone oan handle, such as hypodermics, 
mediciues of a dangerous nature^ treatments and general 
supervitiiun, that u nurne han no riglit to watite her time aud 
energy doing non-essentials. 

le of Mififi Hall's letters contained the following conunent 
upon the Medical Corps men : 

I never saw L-oUetre hoys work the way our orderlies do. 
(Most of them come from excellent families and are of good 
education.) They get up at i a.m.; walk three miles to their 
hreakfast; come on duty at 6 A.M.; sweep, mop, scruh, lift, 
carry heavy loads aud help the nurses in every possible way; 
take 'i>o.ssing," complaints and fault finding from the doctors, 
nurses and patients and have no "comeback"; liave one half 
hour off for lunch ; and go off duty again at six o'clock, drill 
and march three miles home again. Some of the very young 
ones are dears, gentle and sweet, courteous and patient, yet 
not sissy or goody-good at all. - . . 

The Red Cross provided many little comforts for the nnrses 

in military st^rvice in the United States. In thirty-six camps 

aad cantonments, the use of the Red Cross motor cars was 

extended to nurses for shopping trips or for recreation. Tennis 

courts were huilt and maintained. Diiring the intense heat 

of 1918, awnings and porch curtains were provided and electric 

fans, to cool the dormitories and mess-halls. At Fort McPher- 

«>n, Georgia, a committee of women from the Atlanta Chapter 

did mending for the nurses. At Fort Doniphan, Oklahoma, a 

cottage in Medicine Park, about seven miles from camp, was 

rented and three nurses at a time were taken there hy the Red 

Cross Motor Corps for short vacations. Whc^n a lire at Camp 

Dodge, Iowa, destroyed the personal belongings of the nursing 

staff, the Red Cross supplied unifonns aud clothing within two 

hours. Ixians were made to nurses whose res^jurces had been 

completely exliausted. 

Camp life with its hustle and its constant noisi^s ranging 
from the bray of an Army mule to the melodious echoes of 
the biiple calls, was vastly wearisome aud the nurses sorely 
needed a place wltcre they could be alone. The *'Y, M." or lied 
Cross huts were always crowded with visitors and the sight of 
ere and their friends and families who gathered there was 
g the last things which tired nurses wanted to see after 
or ten hours on duty in the wards. Yet these placea and 



S98 HISTORY OF AMERICAN RED CROSS NURSIXG 

the rcK)ras in the uuraes* quarters, shared by otliera with nerves 
equally taut, were their only refuge until the Red Cross built 
special reereatiou houses for nurses. The following U-tter 
from a nurse at Camp J— — — is quoted to show the need for 

these buildings: 

... If we could in our hearts wish you such luck, we 
would wish you were here; for our sakes, though, and not for 

yours. Miss , who has heen in the service for alM»ut 

a year. Is our chief. At first we hoped for some sort of home 
life. . . . Our quarters are built probably like those at every 
other cantonment. As you euter, there are small rooms ou 
either side of the hall. Our chief nurse insists that there is 
no provision for a silting room in these quarters for nurses, 
though the rooms are not yet all filled. 1 told her that I 
never would believe that anybody meant to set fifty nurses 
down in the woods without some place to receive a guest. 
Several people have callerl whom we coxdd not invite in and 
several more have nsked t« call. It hurts my feelings to have 
to say "no." We have five hundred pati«uts and work on tlie 
wards goes smoothly. When we get off duty, we go to bed to 
get warm and because there is no other place to go. 

The Army deplored the luck of recreation rooms and other 
facilitie-s and in almost all cases later supplied attractively 
furnished living-rooms for the nurses, but in tlie interim the 
Ited Cross recreation houses tilled a great need. 

At a total cost of $245,000, the American Red Cross built 
these recreation houses for the exclusive use of the nurses in 
thirty-seven camps, cantonments and training centers. Though 
outwardly these structiires resembled in their monotonous gray- 
ness an ordinary barrack, within there was quiet and comfort. 
Each had a large assembly room, bright with cretonne hangings ; 
at one end of it wicker chairs stood oozily about a deep-throated 
tire-place. In the rear of the building was a small kitchenette, 
in which the nurses might prepare afternoon tea for their 
friends. Nearby was a laundry. A balcony encircled the assem- 
bly room and afforded the nurses a sewing room and small 
alcoves where they might read, write letters or sen'e supper. 
There waa a library and many of the books brought welcome 
relaxation to nurses wearied of bandages and the care of sick 
men. 

Encircling the military boundaries of the cantonments were 
areas in which the many types of people who follow an army, 





A RecrMtion House biiilr Ity tli«> Amrricnn KM Croes for the mtrfiing staff 
of tbe U. S. Arm}' Base Hoftpital at Fort McUeury, Maryland. 




THE EUROPEAN WAR 



399 



gathered to ply their trades. The sanitary conditions prevailing 
in stalls where food and soft drinks were sold, in daucc-halls, in 
shooting galleries, in motion-picture theaters and in houses 
where soldiers, eluding the sharp discipline by which the Army 

■ endeavored to check such practices, met immoral women^ di- 

■ rectly affected the fighting strength of the new Armies. The 
United States Public Health Service, therefore, drew cordons 
of sanitary protection around the camps and cantoimionts, 
calling these outlying districts extra-cantonment zones, and, in 

■ o*(iperation with the Army and with the Red Cross, assigned 
trained sanitarians and public ht'ulth nurses to these areas to 
safeguard the health of the soldiers by bettering the general 
health conditions in th(^se localities. 

While sanitary officers of the U. 8. Public Health iService 
supervised the drainage of malaria infested swamps and ditches, 
condemned the venders of dirty or tuberculous milk and rigidly 
ferreted out the carriers of communicable diseases, Red Cross 
public health nurses assisted in clinics, dispensaries and isola- 

Ition hospitals, or **followed up'' cases into homes surrounding 
the military areas. Varied and interesting indeed were the 
duties of nurses assigned to these health zones. A nurse wrote 
in the Military Number of the Joum^xl: 



Our district, covering a territory of five miles about a camp, 
consisted of the city of Spartanburp, South Carolina, of about 
twenty thousand inhsbitants in nonual times, but now of at 
least double that number. In tlio numerous cotton-mill vil- 
lages outside the city, the population comprises about twenty- 
five hundred. There were a few farms with small groups of 
negro laborers and tenants. 

Our imit was part of the U. S. Public Health Service. The 
director and the larger part of the unit was U. S. Public 
Health Ser\*ico personnel, hut we know nn difference save that 
of the uniforms. We had a car for the use of the nurses. 

The city had a board of health, a full time director of 
health and one puhlif* health nurse who acteil as quarantine 
officer and clerk ; she investigated cases of illness and gave 
instructive care. There was no county health nfticer, no free 
hospital beds or clinic facilities. A local physician made 
charity calls on a fee basis. There were good schools with an 
enrollment of about four thousand children. No systematic 
medical inspection of schools was being done, but volunteer 
inspection had been made. No follow-up work had been 
unaertaken. 



400 HISTORY OF AMERICAN RED CROSS NURSING 



During tJae second week after the arrival of this unit, several 
cases of typhoid fever were reported in nearby cotton villagea. 
The Red Cross public health nurses immediately visited the eases 
and gave instructive care. The sanitarians investigate<l the 
water and nulk supply. The wnter came hirgely from shallow 
wells, all of whieh were found to be eontamiuated, some to the 
extent of ninety-eight per cent bacillus ooli. The director 
of the unit immediately eloaed tlie mttat dangerous wells and 
initiated other forms of health protei'tiou, with such success 
that neighlK)ring villages also having typhoid cases, askod for 
similar service. 

How eflFective the tmit was is shown in the nurse's short state- 
ment of accomplishment: 

Before we had been in the field two months, we had as oui 
nursing staff the supervising nurse and assistant, paid by the 
Bed Cross; a school nurse, paid by the U. S. Public Health 
Service; and the city health department nurse. This co- 
ordinateH all the uurying service in this zone. We organized 
A council of social agencies and had regular monthly meet- 
ings. Mary E. Lci»t, suix^rvisiiig nurse for the U. S. Public 
Health Service, suggested rules which were approved by our 
medical director. 

Often the work was of the most primitive type. Mary ' 
Pritchard (Poli-clinic, Chicago) wTote in the Military Number 
of the Journal, the following account of her work in the canton- 
ment zone at Charlotte, North Carolina: 

When I came here on short notice six months ago, 1 had 
visions of Hoin^ jrenoral visiting nursing. V\H)n arrival they ' 
informed me that I was to do tulterculosis work. The ono 
visiting nurse in town, who was supported by the churche?. 
gave care to bedrid<len cases when she had time. An indus- 
trial nurse looked after insured cases. 1 liad to cover a city 
of fifty-Gve thonsnnd inhabitants, besides tlie mill villagcct. 
We often walked ten and twelve blocks at a stretch to make a 
call. Outside the heart of the city some of the districts do 
not know what a sidewalk or a bit of pavement is; the soil is 
red, sticky clay. Snow, rain and mud makes you stick and 
slip and siuk over your rubbers, ford creeks, climb up embank- 
ments and hurdle ditches. 

The population incladcd mill-hands, foreign and native, 
white and colored. Miss Pritcbard's report continued 




THE EUROPEAN WAR 



401 



The colored districts have email separate houses or cabins, 
usually old and dilapidated. About half of these have no 
Bewer connections and those which have are very poorly 
equipped with the outj?ide tluab toilets, so often out of order. 
The only means of heating in mo.st canen i.s Uie old-time Hre- 
place. . . . When a nurse wants hot water, all she has to do is 
to set a pan of water into the fireplace. 

The mill houses Ufjually have four or five rooms; they are 
better constructed and kept up than the houses built to rent, 
but are terribly cold in winter. Only one of the eleven mill 
villages has sewer connections. Two mills have put in aseptic 
tanks for the outside toilets; the others will be compelled to 
do so this spring on account of the camp being here. We have 
the problem of the lodger, both male and female, in the mil) 
homes as well as among the colored people. 

Miss Pritchard described some of the difficulties under wbicb 
the unit set to work ; 



I first called upon the local physicians. Three had their 
oflice girls inquire very carefully if I were soliciting funds for 
the Red Cross before they would consent to see me. 

Most of them thought that there was a great deal of tuber- 
rulot'is here which was only being re^icbed by the physicmns 
after the hopeful stage was past. The state sanatorium had 
such a long waiting list that such patients as would consent to 
go so far away from home usually die<I before there was a bwl 
for them. As there was no system of follow-up work, home 
care had proven very unBatisfat:tor)'. Tlie colored physicians 
were deeply interested, speaking especially of the problem of 
house infection. One tuberculous family would move out and 
a healthy one move in only to become infected, and this 

firoeess would be repeated over and over. Susceptibility, poor 
iving conditions and tlie fact that patients were so loath to 
admit that they had tlu' disease, as it kept them from getting 
employment, matle their work most discouraging. 

A young negro man came to the dispensary about three 
jks ago, referred by his doctor for a diagnosis. He prove^l 
be an open case of tuberrulosis and seemed intelligent and 
cooperative. I told his mother what liis trouble was and made 
quite satisfactory sleeping arrangements for him. On my 
next visit, the old lady informed me that she never heard of 
aneh foolishness and she was going to take her tmby (who is 
twenty-six) and move away from here; he only had a cold and 
1 "needn't ter come interrogatin' round dar any morel'* 



402 HISTORY OF AMERICAN RED CROSS NURSING 

Contact between carriers of commuuifable diseaflca nnd the 
soldiers in nearby eautonxneuts was often direct Alias PritcLard 
wrote: 

This work, done primarily to prot*^ct the troops, has brought 
out some interesting facts. Two colored women came to the 
dispensary, one an old lady going blind nnd the other with a 
cough of long standing. One was fuund to be syphilitic ami 
the other an open v&^e of tuberculosis. Both had been doinir 
soldiers* Matching. In another squalid liome I found the 
mother of two tuberculous chihlreu ironing the soldiers 
clothes nnd putting them ou a lilthy bed. 

1 was also assigned to the venereal clinic, maintained by th 
U. S. Public Health Service. Two physicians of this service 
are in ntteadance. A nurse, formerly connected with the 
medical social service department of a large city hospital, 
was assigned by the Ked Cross to do dispensary and '*follow- 
up*' work. A male nurse assists in the clinic. It is estimated 
that forty per cent of the colored people, who comprise on 
third of the population here, have veuereal infection; the pe; 
centoge is almost equally high among the whites. 



Emily C. SnivQly (W. C. A. Hospital, now Jennie Edmonson 
^lemorial Hospital, Council Bluffs, Iowa), sujiervising nurs 
of the Red Cross Sanitary Unit No. 5, wrote in the Militar 
Number of the Journal: 



1 



When necessity demands, as it did in our extra-cantonment 
zone when a typhoid epidemic was raging, the I'. S, I'ublic 
Health Service or the American Red Cross scruls a laboratory 
car all equipped to take cure of all bacteriological work until 
the local laboratory can be established. 

The laboratory test is the only positive proof of diphtheria.^H 
. . . The taking of throat nnd nose cultures by the nurse is 9^U 
very iniportfltit part of her w(trk. both in diphtheria and ^^ 
meningitis. The actual knowledge that is obtained in regard ^j 
to milk is invaluable. Samples of milk are collected regularlf^H 
from the local dairymen while on their routes and systematic^^ 
examination is made in the laboratory to determine tlie chemi- 
cal and bacteriological contents and value for infant feeding.^J 
Kxamination is also made to detect any adulteration. preserva-^| 
tivcfl or coloring matter, which are so detrimental to the ^* 
health and life of innocent babies. . . . It did not take long to 
convict a man for adding formaldehyde to his milk, when the, 
baby of the chief of police was ill from that cause. May the: 
day be hastened when those who are in power will be aai 




THE ELKOPEAN WAR 



403 



interested in protecting the babies of the unknown mother and 
father as they are their own ! 

The analysis of specimens in the lahoratorj car, which led 
to the diagnosis of venereal disease, was one of the most im- 
portant phases of extra-cantomneut zone work of this type. 
Miss Snively wrote: 

In the sanitar}' zone, liquor, vice and disease are the three 
foes which are fought. The liquor proijleni is handled by the 
police, but vice by lH»tb iHVlite niul hralth (le|iartrnent». Any 
prostitute can be taken by the police to the health officer . . . 
and in a very short time it is known poi^itively whether that 
girl is diseased. If [the reaction isj negative, she is released; 
if positive, she is put away so as to satepinrd the soldier. The 
farm adjoius our city, so the deputy state lipaltli officer . . . 
defines the farm as the place of isolation. Meilical treatment 
is given and no one is released until three smears are taken 
which prove negative. A splendid woman is superintendent 
of tliis farm and these girls are surrounded with such good 
wiiolesomc environment' that many have more home life than 
they have had for years. 

When the War Council of the American Red Cross went out 
ttf ofhce in Fohruary, IHly, its cliniruian published a report 
giving in statistical form the tinaiices and accomplishments of 
tbe society during the period wlien it was operated by this 
body, May 10, 1017 to February 28, liMJ). This rejxirt states 
that Red Cross public health nurses assigned to sanitary zones 
paid a total of 34:J,943 nursing visits. The number of new 
patienta visited were 53,018; the nursing visits were 90,C02; 
the instructive visits were 104,818 ; tbe school visits were 21,004 

d tbe "follow-up'* visits were 73,811. In the field of seh(X>l 
ical inspection, inspection work was done in 5(i2 schools; 
229,030 children were examined; 81,083 children were found 
to be defective and 4381) corrections were reported to have been 
made. 

Public health nurses in extra-cantonment Kones rendered 
yeoman service in the pundemic^ of Sjmnish Influenza which 
swept the ernintry during the autumn and winter of 1018-1019. 
Rupert- Blue, then Siir^-on General of the U. S. Public Health 
Service, cited several heroic examples; 

At Muscle Shoals Sanitary District, on the night of Octo- 
2, a Ked Cross public health nurse, assisted by two en- 



};& 



4M HISTORY OF AilERICAN RED CROSS NXRSlNQl 



\, wtemted mad cand far on* kmdrBd mad tkattj- 
patKSiU, awo Bg wIkmb thm vs« onlj ant Jctth in tluve 
Ib UKiUirr inrtum s pablir health nvree vorkcd for 
eight boon, tho«i|:h herself il]« sad after 6r^ hoor^^ 
ntuinpd to dotjr. In rtill ABothcr iovtuice, a psblac 
want va» o« dvtj fortr-cight hvaia with 011I5 tvo 
ileep. Thk ataie none paid nme hondnd Tvita is 
Alamna, in the period of one week. 



Within mQiUry faounda, the situation was eqnallv 
Cboditiooa at Camp Bodge, as reported bv the Red Crooa 
Director, Departmcut of Militant' Relief, were tvpicml of 
cantoaments. On Septeaiber 2U^ tbe total Dumber of patients 
the baae hospital was 1^64, with 245 nurses on dnrr. On 
October 10, there were 7863 patients^ with seren deaths and 
443 minea on dnt^. Six days inter 51H»f> patienu had been 
adttHted, 56 bad died and 59.% nurses were on dntr. An increase 
of ODe fanndred and tifty per cent in the cantonment nursing 
staff waa significant of the great activity on the part of the 
Red Croaa m securing nurse? for such service at a time when 
tbe Army waa also endeavoring throu^ Red Cross effort to 
aeod overseas one thousand nurses a weelc The nurses were 
mobilized for Camp Dodge through a nurses* registry in Des 
Moines and were brought out to the camp in %'ehicles of the 
Bed Cmm Motor Corps. They were housed in the nursea' 
dormitorit*« and in the Reil Cross recreation house. 

Many of these nurses had been sent from the Department 
of Nursing at Red Cross Central Division beadquarte 
Chicago. Mias Ahrens described the ejiodus: "At a few ho 
notice, one tbftusand ntirses, old ones, young ones, Red O 
nurses and nurses not enrolled, nurses available for servi 
later on and nurses who would never be eligible for permanent 
enrolhnent, packed their kits, boarded the trains and proceede^y 
like soldiers to the canips.** ^H 

The official sunimarv prepared by Colonel Leonard P. Ayrcs, 
chief of the Statistics Branch, General »Statf, U. S. Army 
ftated tliut '^thc hospital capacity in this country (112,3 
beds) was exceeded only during the influenza epidemic, when 
became m-cftssarv to lake over barracks for hospital pu 
poses."* The fact that four deaths per thousand soldiers 
occurred each week in the United Slates during October a: 

•"T)io War with Ocmuny/' pp. 120-130. 
•ibid,, p. 120. 



Dent 
teri^U 

Ti^m 

put 
leU 

i 




THE EUROPEAN WAR 



405 



November, 1918, shows the virulence of the disease. This loss 
of life was, indeed, a tragic accr^mpauinient of war. 

An interesting experiment in the assigiunent of colored 
nurses to a military cantonment hospital was developed at 
Camp Sherman, Ohio, duriuji; tlie intlueuza epidemic. The 
question of utilization of colored nurses had Ijccu th(f cause of 
ptaloilged discussion between the Surgeon Geuerurs office and 
the American Red Cross. At a meeting of tlie National Com- 
mittee on Red Cross Nursing Service, held in Continental 
Memorial Hall of the Daughters of the American Revolution 
on December 5, li»ll, the following action was taken regard- 
ing the enrollment of colored nurses: 

The question of the enrollment of colored nurses was dis- 
cussed at length and in the meantime a cunference had been 
held with tlie Surgeon General in regard to the appointment 
of colored nurses as members of the Army Nurse Corps, 
Owing to the impossihility of securing proper quarters for 
them, it has never been the poliry of the Surgeon General's 
oQiee to consider the appointment of colored nurses. 

rln view of this fact it was moved by Mrs. Draper and 
seconded that for the present, at least, colored nurses should 
not be enrolled for service under the Red Cross. The motion 
was («.rried/ 
The Minutes of the National Committee on Red Cross Nurs- 
ing Service for a meeting held June I**, 1917, recorded a mo- 
lion made and carrie<l which approved *'a plan for the utiliza- 
tion of colored nurses in connection with base hospitals, if such 
were organized for colored troops alone.'' This plan was modi- 
fied at the next meeting of the NatiomU C<jimuittee, held on 
June 20, 1917: 

The chairman stated: The next question is the assign- 
ment of colored nurses to duty. The un<lerstanding was that 
we should not open a general enrollment for colored nursea, 
but if the Surgeon General finds a way to use them (as seems 
possible in Iowa) we will enroll them for that special service, 
securing colored nurses as they may he needed, to go out in the 
uniform of the Ked Cross nurse and to be given tlie Red Cross 
badge. It was not a general enrollment, but when enrolled 
they would he on the same footing u[M)n assignment to duty as 
were other nurjses. 

inut«ft of llie National Cumuitti'e on Red Crosa Nursing Service, 
I. pp. 4&-47. 



406 HISTORY OF AMERICAN RED CROSS NURSING 

After some general diwussion, the resolution in regard to 
colored nurses, oifenMl at the meeting on June 16, was chango<l 
by the inbertioii of the words: "Wherever there i8 opportunity 
for aasignmejit of colored uur^'es for duty, they be enrolled fo 
that service and assigned to that duly." Motion carried. 



m 



On December 18, 1917, Miss Delano asked Miss Thompson 
repunlin^ the prolmbility of the Siirger>n General iiRfli|2^iing 
cclort^d nuraea to duty. Misa Thompson replied the following 
day that there was no imnie<iiate prospect of calling upon them, 
but she atated that slic tbought it would be advisable to enroll 
them **wit,h the understanding, however, that their assign-^ 
ment is an uncertain proposition." ^jM 

During the influonzu epidemic, the base hospital at Camp " 
Sherman, Ohio, asked the Local I^?d Cross Chapter on Octo- 
ber 10 to supply it with additional nurses. Among those re- 
sponding to the call was a registered colored nurse whose serv- 
ices were refused. Catherine L. Leary, then chief nurse at 
Camp Sherman, wrote November 21, 1918, to Miss Thompson, 
giving the reason for this refusal: 

The evening this colored nurse arrived at Camp Sherman 
for duty, the rcspontje to the appeal tlirough the Ked Cross 
had been acted ui>on so qnickiy that wv lunl many nurses at 
the time. I therefore had to refuse a luiinber that day, ^raong 
whom was tliis attractive and intelligent young colored 
woman. 

She seemed much disappointed after having come all the 
way from Columbus. 1 offered her a bed for the night, which 
she accepted and later refused, deciding to return to Columbu» 
as her pervices were not needed. I felt very sorry that she 
should have to go away disappointed, so I paid her fare to and 
from Columbus to the camp, telling her that when our quar- 
ters for colored nurses were ready, we would be glad to nave 
her when we needed her sernces. ^^ 

All emergency detachment consisting of nine colored nurses i 
from Frcedmau's Hospital, Washington, D. C, and of one 
nurse from Buttle Creek. Michigan, was assigned during tbo 
early part of December to Camp Sbeniuui. Aileen B. Cole, 
reserve nurse*, wrote iHHvmlx'r *i of their rcoeptiou: 

We first interviewed the chief nurse, who received us very 
cordially. We then visited the colored hostess house. Dr. 




THE EUROPEAN WAR 



407 



Amanda Gray, of Washington, who is rhief hoetess there 
intmduccfl us to the pieste. We also attended the colored 
Y. M. C. A. perviees that evening and it warmed our hearts 
to see how thoroughly glad those boys were to have us with 
them and to hear tliein clioer I 

We are accepting conditions exactly as we find tliem. We 
have met with individual prejudice, hnt, generally speaking, 
every one so far has been exceedingly kiiid. 

Clara A. Rollina, reserve nurse, described their quarters: 

Each nurse has her own room and everything to make her 
feel at home. Out living room is to have a piano, Victrola, 
desks, chairs and many other comforts to break the monotony 
of camp life. 

The work is very interesting. Our boys are in the same 
wards with the white soldiers. Memhers of our unit have 
been as.signed to the accident nnd wounded from overseas 
ward ; surgical, car. nose and throat ward ; the pwychiatric; the 
observation and contagious wards; and medical wards of 
various types. MiHS Ball is the only matfsewie in the hospital 
and they were very glad indeed to have her. 

ilarv M. Rolx^rts, chief nurse of Camp Sherman at the 
time when the detachment of colored nurses was ordered there, 
wrote; 



Clara A. Rollins I hope I shall never forget, because of her 
splendidly cooperative spirit shown throughout her service at 
Sherman. No matter whut problem arose in regard to the 
colored group, I could always depend on Miss KolJins to think 
the matter through with me and to cooperate with auy solution 
I might have to offer. She was so well loved by tlie Ix)y8 in a 
surgical ward that I never changed her from her first position. 
I recall one amusing instance which occurred when a change 
of personnel in the ward seemed logical and imminent. A 
request, signed by every man in the ward, was sent to my 
office begging that Miss Ifollins he not taken from them. The 
boys always called her "the Majt»r" aiid the day before she 
left camp they had a special cerenioii)' and made her a "Lieu- 
tenant Colonel." As I recall that group of patients, there 
were very few colored men in it. 

Of the living conditions and social life of the colored nurses, 
Mine Roberts wrote: 



408 HISTORY OF AMERICAN RED CROSS NURSING 

They ha«l their own qunrtprs with its dining room and 
kitchen. We very early made connection with the colored 
"'Y" in camp and such other arrangements ae we could for a 
rea^onahly noriiml sncial life. After their conference with 
me, they a^Teed that they would not expect to share in the 
social activities of the white nurses. It was to he understood 
that they were most welcome at all the "program" affairs. We 
were careful to reserve the Hed Cross recreation hut for their 
use occasionally, as we reserved it for other groups for 8]>ecial 
occasions such as parties given by the aides, the students or 
the graduate nurses. 

Of the value of the work rendered by the unit ae a whole, 
Miss Roberts wrote: 

I do not mind saying that I was quite sure, when orders 
came for the colored group, that I was al>out to meet my 
Waterloo, My feeling now in that it was a vahiahle experience 
for them and for me. They really were a credit to their race, 
for they did valuable service for our patients and it was a 
service that the patients appreciated. I now find myHf 
deeply interested in the problems of all colored nurses and 
believe in p:iving them such ap})ortunities as they can grasp for 
advancement. . . , 

Tlio War Dopnrtnicrit reported that the senuccB nf seven 
members of this detacbrueut nf colored unr8*»H were satisfac- 
tory in every respect Two were recorded as "Grade 2." This 
was Inglily creditable in view of the fact that tlie detachment 
was the first one of cidorcd nnrsca in the service. 

A second detachment nf colored nurses was organized and 
assigned early in December, 11)18, to service at Camp Grant. 
Of this group, Anne Williamson, then chief nurse of Camp 
Grant, wrote: 

In the latter part of the year, li)18, our commanding 
officer. Colonel H. C. Michie, received definite information 
that we were to have a contingent of ctdored nurses at Camp 
Grant. Action to conrtmct quarters for their acconrunodatiou 
was immediately taken and by the time that nurses arrived 
their home of about twenty rooms was in readiness. 

A colored cook and a maid were assigned to this group. 
One nurse was apiminted h()usektM»pcr, ordered supplies, 
planned the meaU and under the direction of the chief nurse 
conducted the household affairs. 



THE EUROPEAN WAR 



409 



The first nurse reported for duty December 3, 1918, and 
■within a few days about thirt*'en iiutsph had arrived. Several 
of the nurses were from the Linioln Hospital, New York City, 
one from the Freedman's Hospital, Wasiiington, D. C, and 
several from Provideuee Hospital, Chicago. 

Since the white and colored patients were not assigned to 
separate wards, these nurses were asfiigned to the general 
wards under the direction of the head nurse. They were 
serious-minded, quiet, business-like young- women, well quali- 
fied to take charge of wards, had our colored patients been 
segregated. For a time, colored troops were stationed at 
Camp (Irant and the nnrpps had opportunity for quite a bit of 
social life. They gave i*everal dinners and dunces, entertain- 
ing the officers from the troops mentioned. I iielieve that one 
Qurse subsequently married an otiicer whom she had met at the 
camp. 

Colored nurses served with distinction during tlie influenza 
epidemic at Camp Sevier, South Carolina. Sayres L. Milli- 
ken, who was at the time chief nurse at Camp Sevier, wrote: 

At the peak of the influenza epidemic at Camp Sevier, 
South Carolina, about fifty per cent of the nurses were off 
duty, sick, and the hospital contained about 3000 patients. 
It became necessary to employ locally every nurse who could 
be secured. A medical officer on duty at Cnmp Sevier who 
was from tliat section of tho I'onntry said thiit there were 
several goo(\ c-olored nurses who could be secured in the vicin- 
ity of Spartanburg, South Carolina. The idea of securing the 
rrvices (»f (-olorcd nurses did not immediately meet with 

ithusiasm, as fully seventy-five per cent of the nurses were 
women of Southern birth and had very positive objections to 
working with colored nurses. The need was so imperative that 
it was decided to employ them, furnishing them quarters and 
a mesa separate from the white nurses. 

About twelve reported for duty. They were assigned to the 
wards in the hospital in subordinate positions and with the 
exception of one or two who were not young enough to adapt 
themselves to the trying conditions under which every one was 
working, these young women were found to be well-trained, 
quiet and dignified, and there was never at any time evidence 
of friction between the white and colored nurses. They served 
for a period of possibly tliree weeks. ... 1 should say that, 
although these nurses had no opportunity to display executive 
ability, they did and can fill a valuable place in tlie nuraing 
profession. 



410 HISTORY OF AMERICAN RED CROSS NURSING 

Foiir types of asaignment characterized war nursing service 
in the United States. At the base of the military pyramid were 
the barrack wards of the cantonments whore the recruits of 
the Selective Draft were trained. The National Guard did 
not need so thorough a schooling, military theorists argued, 
and it was housed under canvas. Sometimes a nurse found 
herself in the shining tiled corridors of Walter Ueed or Letter- 
man U. S. Army General Base Hospitals, permanent estab- 
lishments of the Regular Army, Fortunate indeed was the 
nurse whose orders took her to an embarkation encampment I 
Stella Godard, reserve nurse, w^rote in August, 1918, from 
Camp Stuart, Newport News, Virgina; 

After the preliminary bueine&s of arrival and reporting my- 
self to the chief nurse, I was taken over to a long barrack-like 
building and found a bed aUottod to nic in a dormitory with 
about fifty other nurses. 1 mui?t ailniit that this, for a first 
impression, was rather flaunting. The pi see was littered 
from end to end with i-lothes, trunks and grips. Even the 
beds themselves were occupied, some by night nurees trying to 
sleep, others by day nurses, reading, writing, sewing and 
resting. I could see no possibility of the faintest trace of 
privacy for the undressing atid the dressing hour. Neither 
was there any and later I learned there was no water for anv 
purpose nearer than the main liuildiiig. AVe had rough 
wooden shelves to put our Ihin^rs on and a few nails on whieii 
to hang our clothes. To get a bath we had to walk outside to 
the main building, two blocks away. At all times of the day, 
nurses were to be met d la negligee ])u8i^ing to and from 
tlieir ablutions. When it stormed, the rain leaked down upon 
us from the roof; when it blow, the sand whirled in and almost 
burie<l us, and the flies were a verituhle plague. 

But all this was, I am glad to say, only temi>orary dis- 
comfort, for now we have verj' nice quarters, all brand new 
and clean. I often look back and laugh to think of my 
chagrin and realize tliat it wbk not so bad as it seemed after, 
all. 1 



Here in Hampton Roads were the shifting stgbta and sounds 
of maritime traflic. Miss Godard wrote: ^J 

The hoiipital wards are built facing the fine water front. 
Both day und nipht its ever-changing beauty refreslies and 
charms one. During the day, we see the ships that come and 
go to and from the bus^y ports around here. Transpoi 




THE EUROPEAN WAR 



411 



battleships, coaling vegsels and innumerable other craft lie at 
Hampton Kouds, a great air of indomitable purpose and mys- 
tery surrounding them. Then wlieu night falls, BtillnesB 
fomes over the water and the long road of silver light made 
by the moon ghimmers up to meet the stars. Then, too, there 
are the little birds that live in the reeds and long grasses by 
the water's e<lge, that all night long make weird, restless little 
noises, neither a mng nor a call, but a sound that fills one with 
inexplicable longings. 

The romance of war, now doubly potent because of the ne- 
cessity for absolute 8cerc<'y, enveloped the constant movement 
of the troops. Miss Godard wrote: 

The troops are continually entering and leaving. For a 
few days the camp will be crowded with men busy about their 
drills, parades, exercises, a continually moving mass. 

Several times I have tKtme off night duty to see a regiment 
leaving in the early morning. The colonel addressed his men 
in a few brief words, poignant with pride, hope and high 
courage. The emotion which he would have hidden was evi- 
dent only in the deep vibration of his voice. He saluted his 
men, his officers, then stepped up to the head of his regiment. 
The band struck up, the order rang out and they all swung 
forward with brisk tread, enthusiasm like a glory shining from 
their faces. 

When you stepped out on the front porch that morning, you 
would find the long rows of barracks, the watt-r front and the 
camp streets empty, deserted and silent, a deathly and haunt- 
ing stillness over all, where only a few hours before there had 
been movement and laughter, song and banter, the playing of 
bands and the shrill call of bugles. From two hundred to two 
thousand men had been literally spirited away during the 
night on to the transports and it will be many a long day 
before the tramp, tramp of tlicir marching feet will be heard 
upon this camping ground again. 

By noon, however the vacated barracks and parade grounds 
would be filled again. At the main gate new regiments would 
come marching in, fine bodies of men, neat and trim, their 
overseas caps set smartly on the fiidcs of their heads. Follow- 
ing them would come carts, wagons, trucks laden with para- 
phernalia for horses and men, maguificcnt and Inspiring, 
soldiers and equipment alike the best America has to of!er. 

Twelve thousand, seven hundred and ninety-three members 
of the Army Nurse Corps, regulars and reserves, served in 



412 IlISTOUY OF AMERICAN RED CROSS NITRSING 

military cantonment and camp hospitals in the United States 
during the Eiiriipoan War. A certain amount of gossip was 
whispered about regarding the discomforts, the unreasoning 
discipline, the overwork, the monotoujy and the loneliness of 
this branch of the service. In sharp contrast to the few 
nurses who compluiued bitterly yet humanly of their assign- 
ment to cantonment duty, there were many who looked behind 
the surface annoyaucea and inconveniences of camp life, the 
tedium of nursing accident cases and minor ailments and the 
lack of consideration on the part of some of their 8up*.*rior 
officers and saw the real meaning of cantonment duty, sensed 
its tremendously vital part in the war plan and accepted their 
assignment like tlu^ g(jod soldiers that tliey were. This sports- 
manlike and altruistic spirit was wrll expressed in the follow 
ing letter written by a reserve nurse: 



ii 



TJ. S. Army Ba«e Hospital, 

Camp , May 25, 19Ii 

And so the summons came and I answered. I am one of 

the one hundred and forty-eight nurses at Camp , an 

atom. For as I write, there march l)Gfore me sixty thousand 
fighting men, undaunted, ready and supreme. Here we stand 
together, one hundred and forty-eight nurses and sixty thou- 
sand of the youth of America. 

The niimlKT on my Re<l Cross pin is . In Ortober, 

1